bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a gamification strategy to prevent childhood obesity in schools: a cluster-randomized controlled trial
Authors: Peña Sebastián , Carranza Macarena , Cuadrado Cristóbal , Espinoza Paula , Müller Valeska , Cerda Ricardo
Published: June 2020

Introduction

School-based interventions to prevent obesity have shown heterogeneous results. Recent school-based trials with “negative” have cast doubt on their effectiveness. In the Juntos Santiago trial, we used an innovative, theory-based gamification strategy to increase motivation and participation in healthy behavioural changes. This is the first trial, to our knowledge, to use gamification to prevent childhood obesity.

Objective

To examine the effectiveness of a multicomponent gamification strategy to prevent obesity in 5th and 6th-grade schoolchildren in Santiago de Chile.

Materials and methods

School-based, parallel cluster-randomized controlled trial. 81 schools in two municipalities in Santiago, Chile, with more than 40 students in 5th and 6th grade altogether were eligible. Schools were randomized and sequentially invited to participate. The multicomponent intervention was a gamification strategy with four components: (i) healthy challenges (snacks, steps and healthy activities); (ii) gamification incentives, such as points, levels, leaderboards and badges; (iii) rewards (infrastructure and fun activity) and (iv) an online platform for parents and students to monitor the progress. Participants were followed up at 5 and 8 months. Pre-registered primary outcomes were body mass index (BMI) z-score and waist circumference (WC) at 8 months. Secondary outcomes were BMI and systolic (SBP) and diastolic blood pressure (DBP) at 8 months. Multilevel analysis adjusted for individual and school-level covariates were used.

Results

24 schools (9 controls) and 2333 students (709 controls) were assessed at baseline and 2264 students (689 controls) were assessed at 8 months. The mean BMI z-score was lower in the intervention group compared to the control group at 8 months (mean difference -0.132, 95% CI -0.249; -0.014), while no difference was observed for WC. Mean BMI and SBP were lower in the intervention arm compared to the control arm (mean difference for SBP -0.139; 95% CI -2.39; -0.40). No difference was observed for DBP.

Discussion

The gamification strategy appears to prevent childhood obesity and reduce systolic blood pressure in school children in Santiago. These effects are larger than the pooled effects from existing meta-analyses. Further research should identify which components of the gamification strategy were more effective.

Trial registration

ClinicalTrials.gov NCT03459742

Funded by

Mayors Challenge 2016, Bloomberg Philanthropies
Low-FODMAP Diet and Its Role in Irritable Bowel Syndrome (IBS) Management
Authors: Cardoso Fábio , Azevedo Mónica , Oliveira Bruno , Poínhos Rui , Carvaho João , Almeida Rita , Correia Flora
Published: June 2020

Introduction

Irritable Bowel Syndrome (IBS) is a functional and multifactorial gastrointestinal disorder characterized by pain, abdominal distention and motility changes, currently diagnosed based on the Rome IV criteria. The efficacy of classic pharmacological, psychological and dietary treatments for this condition are generally low. The Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) are short chain carbohydrates poorly absorbed at the intestinal level, fermentable by the microbiota and presumably involved in IBS-associated symptomatology.

Aims

To evaluate the efficacy, feasibility and acceptability of a FODMAP-restricted feeding approach in the relief of symptomatology and in the improvement of the quality of life of patients with IBS, determining the reintroduction of the FODMAP food subgroup(s) involved in the symptom exacerbation.

Materials and Methods

After assessing the existence of initial emotional disorders through the Hospital Anxiety and Depression Scale (HADS) and eating habits, through dietary history, patients diagnosed with IBS were put on a FODMAP-restricted diet for 6 weeks. During this period, the weekly evolution of symptom frequency was assessed. At the end, tests were undertaken to discover the global evolution of the symptoms through the Irritable Bowel Syndrome - Global Assessment Scale (IBS-GAI), the severity of symptomatology through the Irritable Bowel Syndrome - Severity Scoring System (IBS-SSS) and quality of life through Irritable Bowel Syndrome - Quality of Life (IBS-QoL).Subsequently, participants tested their tolerance to various FODMAP subtypes with weekly and isolated reintroduction of these in their diet.

Results

In the 36 participants, with a mean age of 38.8 years, there was a reduction in the total consumption of FODMAP from 22.1 g to 2.1 g (p < 0.001). A moderate or substantial improvement in the IBS-GAI was observed in 88.9%. An average reduction of 235 points in the IBS-SSS (p < 0.001) and a mean increase of 28.7 in the IBS-QoL (p < 0.001) was achieved. The initial anxiety and depression levels were not associated with IBS-SSS and presented an inverse association with the IBS-QoL. There was significant improvement in all symptomatology during the 1st week of total FODMAP restriction, except for constipation with an amelioration observed at the 6st week. There was a frequency of intolerance ranging from 30.8% for fructans to 80.8% for lactose with the reintroduction of the FODMAP subtypes.

Conclusion

A FODMAP-restricted diet, implemented over a period of 6 weeks, is effective in reducing the severity and frequency of GI symptoms and improving the quality of life of portuguese patients with IBS.
Prevalence of sarcopenia in community-dwelling older adults in Ireland: comparison of EWGSOP1 and EWGSOP2 definitions
Authors: Murphy Caoileann , McMorrow Aoibheann , Flanagan Ellen , Cummins Helen , McCarthy Sinead , McGowan Maureen , Rafferty Sheena , Egan Brendan , De Vito Giuseppe , Corish Clare , Roche Helen
Published: June 2020

Sarcopenia is a muscle disease rooted in adverse muscle changes that accrue across a lifetime. It is an independent risk factor for numerous adverse health outcomes. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a definition for the identification of people with sarcopenia (EWGSOP1). In 2018, this definition was updated based on the newest evidence (EWGSOP2), with the focus now on low muscle strength rather than low muscle quantity as the key characteristic of sarcopenia. In addition, EWGSOP2 provides clear cut-off points for measurements of variables that identify sarcopenia. The aim of this study was to determine the prevalence of sarcopenia among community-dwelling older adults in Ireland for the first time and to assess agreement between the EWGSOP1 and EWGSOP2 definitions. In a cross-sectional analysis, 490 community-dwelling adults (age 78.4 ± 8.0 y, body mass index 27.6 ± 5.1 kg/m2) were assessed. Skeletal muscle mass was estimated using bioelectrical impedance analysis, muscle strength was measured via handgrip dynamometry and physical performance via the Short Physical Performance Battery. Sarcopenia was defined according to both the 2010 criteria (EWGSOP1) and the updated 2018 criteria (EWGSOP2). Using the EWGSOP1 criteria, the prevalence of sarcopenia was 7.1% (2.6% sarcopenia, 4.5% severe sarcopenia) and 3.6% were classified as pre-sarcopenic (low muscle mass without a decrement in strength or physical performance). Using the EWGSOP2 criteria, the prevalence of sarcopenia was 5.5% (1.6% sarcopenia, 3.9% severe sarcopenia) and 23.4 % were classified as having low strength but without a decrement in muscle mass. Five of the participants who were classified as sarcopenic (2 sarcopenia, 3 severe sarcopenia) by EWGSOP1 were classified as “normal” using the EWGSOP2 criteria. In conclusion, the prevalence of sarcopenia in community-dwelling older adults in Ireland is in line with the prevalence reported in other European countries using the EWGSOP1 criteria (3.3–11.4 %). To our knowledge this is the first study to compare the prevalence based on the EWGSOP1 and the EWGSOP2 criteria. We report a slightly lower prevalence using the EWGSOP2 definition compared to the EWGSOP1 definition. Importantly however, in contrast to EWGSOP1, the EWGSOP2 definition identified a substantial proportion of older adults with poor strength in the absence of overt sarcopenia (23.4%). These older adults represent a group who would benefit from further clinical investigation and intervention.
An Investigation into the Effects of Stevia on food intake, satiety and blood glucose levels in adults: a small-scale study
Authors: Farhat Grace , Moore Lauren , Moya Inaki , Hall Lindsay , Berset Victoria
Published: June 2020

Non-nutritive sweeteners (NNS) are suggested to reduce sugar and energy content of diet, but there is growing evidence that they can exacerbate obesity and diabetes through increasing appetite and energy intake. Stevia (stevioside extract), a natural sweetener, is being increasingly consumed, yet limited studies have looked at their effects on satiety and energy intake. The aim of this study is to investigate the effects of preloads of stevia on food intake, satiety and postprandial blood glucose levels when compared to water and sugar. Thirty participants (10 males/20 females; 26 ± 10.5 years; BMI: 23.44 ± 3.42 Kg/m2) took part in a three-arm single-blinded crossover trial. On separate test days, they received three different preloads (300 ml) containing water, sugar (60g) and stevia (1g) followed by an ad-libitum pizza lunch after 30 minutes. Breakfast was standardized. Blood glucose samples were collected before preload and lunch, and then at 30-minute intervals until 120 min post lunch. Volunteers recorded their feelings of satiety and hunger on visual analogue scales (VAS) before preload and after meal intake. A one-day diet diary was collected for each test day. Data was analysed using repeated measures ANOVA (SPSS Inc., Chicago, IL, USA). Despite the difference in energy content between preloads, there were no significant differences in energy intake at lunch between the three interventions (F (2, 56) = 0.25, p = 0.78). Furthermore, participants did not compensate by consuming more energy during the day after the stevia preload (1660 ± 584 Kcal) compared to sugar preload (1770 ± 763 Kcal, p = 0.82). There were no significant differences in VAS scores between stevia and sugar preloads, but participants scored significantly higher rates of hunger (before and after lunch) and desire to eat (before lunch) following water preload (p < 0.05). No significant differences between water, sugar and stevia were noted for postprandial glucose levels (120 min post lunch) when adjusted from baseline (F (2, 58) = 2.56, p = 0.09). Area under the curve (AUC) for glucose did not differ between water and stevia (p = 0.2). Results are in line with several clinical trials showing that the consumption of sweeteners does not lead to an increase in hunger and energy intake, and could therefore present a useful strategy to assist with weight loss. Further studies looking at long-term effects of stevia on weight regulation are needed to support these findings.
Associations of chronotype with clock genes polymorphisms
Authors: Maukonen Mirkka , Havulinna Aki , Partonen Timo , Kanerva Noora , Männistö Satu
Published: June 2020

Introduction

Individuals with a later timing of circadian rhythms (evening types) tend to have unhealthier behaviors compared to those with an earlier timing (morning types). Previous studies have shown that evening types have unhealthier diets and later eating times than morning types. Furthermore, evening types bear higher odds for type 2 diabetes and weight gain (women). Circadian rhythms are controlled by clock genes which have an important role in regulating energy homeostasis. Thus far, a number of single nucleotide polymorphisms (SNP) of clock genes have been associated with metabolic disturbances, obesity and dietary habits (e.g., breakfast skipping and macronutrient intakes). Our aim was to examine chronotype associations with SNPs of the 20 known key clock genes which could help to clarify the underlying mechanisms behind chronotype phenotype.

Methods

Our data included 8558 participants (aged 25–74 years, 52% of women) from the cross-sectional population-based National FINRISK 2007 and 2012 surveys. Chronotype was assessed with a shortened six-item version of Horne and Östberg's Morningness-Eveningness Questionnaire (sMEQ) accounting for 83% of the total variance of the original questionnaire. For comparison we used a single self-evaluation question on chronotype from the questionnaire. Genotyping was done using Illumina arrays (HumanCoreExome, Omniexpress and 610K). Linear and logistic regression was used for statistical analysis with the additive genetic model. The analyses were adjusted for age, sex, batch effects and five principal components to account for population structure. The false discovery rate method by the Benjamini-Yekutieli procedure was applied to correct for multiple comparisons.

Results

We found 27 SNPs in two clock genes that were significantly (P < 0.05) associated with chronotype when assessed with the single question. Minor allele carriers of the NR1D2 (Rev-erbβ) polymorphisms (rs4131403A, rs4858095T, rs6794922G, rs4619734A, rs4589882A, rs4321479C, rs6779476A, rs6790557A, rs13095392A, rs4858098G, rs4858567C, rs11717862G, rs7431301A, rs5023610G, rs5847265C, rs5847266G, rs6550823A, rs9882735C, rs7371944A, rs55792500G) were associated with evening type, whereas minor allele carriers of the NFIL3 polymorphisms (rs2482704T, rs2989836T, rs2482356C, rs2440589T, rs9409419G, rs2482702G, rs2482357A) were more likely morning types. Findings were similar when chronotype was assessed with sMEQ but did not reach statistical significance.

Discussion

Our findings indicated novel genetic associations of chronotype with two clock genes that have previously been associated with carbohydrate and lipid metabolism (NR1D2), and with lipid absorption and export in intestinal epithelial cells and hepatic gluconeogenesis (NFIL3). These results expand our knowledge of the genetic basis of chronotype and warrant further studies to replicate these findings.
Differences in gut microbiota composition in metabolic syndrome and type 2 diabetes subjects in a multi-ethnic population: the HELIUS study
Authors: Deschasaux Mélanie , Bouter Kristien , Prodan Andrei , Levin Evgeni , Groen Albert , Herrema Hilde , Tremaroli Valentina , Snijder Marieke , Nicolaou Mary , Zwinderman Aeilko , Bäckhed Fredrik , Nieuwdorp Max
Published: June 2020

Recently, increased attention has been drawn to the composition of the intestinal microbiota and its possible role in metabolic syndrome and type 2 diabetes (T2DM). However, potential variation in gut microbiota composition across ethnic groups is rarely considered despite observed unequal prevalence for these diseases. Our objective was therefore to study the gut microbiota composition across health, metabolic syndrome and T2DM in a multi-ethnic population residing in the same geographical area. 16S rRNA gene sequencing was performed on fecal samples from 3926 participants to the HELIUS cohort (Amsterdam, The Netherlands), representing 6 ethnic groups (Dutch, Ghanaians, Moroccans, Turks, Surinamese of either African or South-Asian descent). Included participants completed a questionnaire and underwent a physical examination and overnight fasted blood sampling. Gut microbiota composition was compared across metabolic status (diabetes with and without metformin use, metabolic syndrome and its subsequent components, health) and ethnicities using Wilcoxon-Mann-Withney tests and logistic regressions. Overall, the gut microbiota alpha-diversity (richness, Shannon index and phylogenetic diversity) decreased with worsening of the metabolic state (comparing health to metabolic syndrome to T2DM) but this was only partially reproduced in ethnic-specific analyses. In line, a lower alpha-diversity was found in relation to all metabolic syndrome components as well as in T2DM subjects using metformin compared to non-users. Alterations, mainly decreased abundances, were also observed at the genus level (many Clostridiales) in metabolic syndrome subjects and more strongly in T2DM subjects with differences across ethnic groups. In particular, we observed decreased abundances of members of the Peptostreptococcaceae family and of Turicibacter and an increased abundance of a member of the Enterobacteriaceae family. Our data highlight several compositional differences in the gut microbiota of individuals with metabolic syndrome or T2DM. These features, confirming prior observations, give some insights into potential key intestinal bacteria related to a worsening of metabolic state. Our results also underscore possible ethnic-specific profiles associated with these microbiota alterations that should be further explored.
Dietary Patterns and Associations with Chronic Diseases of Ageing: Evidence from The Irish Longitudinal Study on Ageing (TILDA)
Authors: O'Connor Deirdre , Scarlett Siobhan , Kenny Rose Anne
Published: June 2020

In the field of nutritional epidemiology, principal component analysis (PCA) has been used to derive dietary patterns, but this has never been conducted in a large, nationally representative sample of older adults in Ireland. The aim was to identify dietary patterns amongst older adults in Ireland derived through PCA and to examine cross-sectional associations with common comorbidities of ageing.

PCA was performed using data from Wave 3 of TILDA (2014), a nationally representative cohort of community-dwelling adults aged ≥ 54 (n = 4,395). We derived major dietary patterns from a PCA of reported intake from a Food Frequency Questionnaire (FFQ). Objective measures for Body Mass Index (BMI), diabetes (HbA1c), bone density(heel bone ultrasound), blood pressure and total cholesterol were collected during a health assessment. The Mini-Mental State Examination (MMSE) was also performed during health assessment with trained interviewers, as a measure of global cognitive function.

Statistical analyses were conducted using multivariate logistic regression, adjusting for age, sex, marital status, income, educational attainment, alcohol consumption, smoking and physical activity.

With the use of PCA, five dietary patterns were identified in the sample - Pattern 1 (fresh fruit, vegetable, fresh fish and dairy), Pattern 2 (confectionary, fatty and processed foods), Pattern 3 (meats, processed meats and salty foods), Pattern 4 (carbohydrates and processed foods) and Pattern 5 (savoury snacks, spreads and processed foods). Those characterized by Pattern 4 were more likely to be overweight (adjusted RRR 0.12, 95% CI 0.05–0.20; p = 0.001), obesity (adjusted RRR 0.18, 95% CI 0.10–0.27; p = 0.001) and have diabetes (adjusted RRR 0.10, 95% CI 0.01–0.19; p = 0.024) after adjusting for known covariates.

Our results suggest that in the older adult population of Ireland, a dietary pattern typified by consumption of refined grains and processed carbohydrates is associated with higher prevalence of overweight, obesity and diabetes.
Dietary deficiencies in middle-aged obese Polish men and women
Authors: Witkowska Anna M. , Waśkiewicz Anna , Zujko Małgorzata E. , Szcześniewska Danuta , Stepaniak Urszula , Drygas Wojciech
Published: June 2020

Obesity predisposes to such health conditions, as cardiovascular diseases, hypertension, diabetes, hyperlipidemia, osteoarthritis. Poor diet is among the common causes of obesity. The purpose of this study was to evaluate the intake of macro- and micronutrients in obese Polish men and women in accordance with the recommended intakes. Two hundreds ninety seven obese men (BMI > 30) and 412 obese women, aged 45–65 years, participants of the population-based cross-sectional Polish National Multicenter Health Examination Surveys - WOBASZ (2003–2005) and WOBASZ II (2013–2014) were selected for the study. Nutritional data were collected using a single 24-hour dietary recall method. Nutrient content in the diet was calculated according to national tables of food composition and compared to the current dietary recommendations. Anthropometric measurements were recorded using standard anthropometric procedures. Descriptive statistics were used for the determination of means, standard deviations (SD), median, and for the percentage analyses of the macro- and micronutrient intakes. In men the average energy from fat was 37.8%, while in the women 35.5%, compared to 20–35% recommended, while for saturated fat it was 13.95% in men and 13.37% in women, compared to the recommended level of less than 10%. A low percentage of men (M) and women (W) implementing dietary recommendations for vitamin D (M = 3.03%, W = 0.97%), calcium (M = 9.09%, W = 7.52%), magnesium (M = 22.22%, W = 35.92%), saturated fats (M = 17.85%, W = 19.90%), folates (M = 22.90%, W = 14.08%) and dietary fiber (M = 31.31%, W = 18.45%) was found. The highest percentage of participants who consumed the recommended amounts was found in the case of iron (M = 95.62%, W = 84.22%). About 1 % of obese participants were on a weight-reducing diet, while 10% of men and 11% of women were on other diets (low-cholesterol, low-fat, diabetic). In this study energy intake from total and saturated fat was higher than the recommended level. This indicates the incorrect structure of energy in the meals of obese middle-aged people. The mean intake of dietary fiber was below the recommended 25 g/day both in men and women. An adequate fiber intake ensures better glycemic control, satiety and prevents constipation. A limitation of this study is the use of a 24-hour dietary recall method, that may not reflect long-term food consumption. Also obese people tend to underreport how much food they consume. However, in this study about one tenth of the participants reported that they are on a diet. This study showed that dietary deficiencies are common in middle-aged obese Polish men and women.
Longitudinal age-related changes in cobalamin and folate status in community-dwelling older adults
Authors: Jungert Alexandra , Zenke-Philippi Carola , Neuhäuser-Berthold Monika
Published: June 2020

Advancing age is regarded as a risk factor for an insufficient cobalamin and folate status. However, longitudinal data are lacking and little is known on the impact of age in subjects ≥ 60 years after considering potential confounding factors. Therefore, the present study investigates age-related changes in cobalamin and folate status in older adults by using longitudinal data of 332 German subjects aged ≥ 60 years, who participated in the longitudinal study on nutrition and health status of senior citizens in Giessen (GISELA study). All subjects had complete data records on at least three follow-ups between 1997 and 2014. The mean follow-up time was 12 years. Fasting serum concentrations of cobalamin and folate were determined with SimulTRAC-SNB radio assay kit. In each follow-up, body composition (bioelectrical impedance analysis), dietary cobalamin and folate intakes (3-day estimated dietary record), supplement use and lifestyle factors (questionnaires) were assessed. Linear mixed models were used to analyze age-related changes in serum concentrations of cobalamin and folate by considering sex, absolute fat-free mass, supplement use, dietary intakes and smoking behavior as potential confounding variables. Furthermore, due to the metabolic interaction of cobalamin and folate, linear mixed models implemented a mutual adjustment of serum cobalamin and serum folate. At baseline, 11.4 % and 7.8 % of the subjects had cobalamin concentrations < 148 pmol/L and folate concentrations < 10 nmol/L, respectively. In contrast, dietary cobalamin intakes < 4 μg/d and folate intakes < 300 μg/d were found in 24.4 % and 76.5 % of the subjects, respectively. Without adjustments, a positive influence of age on serum cobalamin [parameter estimate (95 % CI) = 4.57 (1.67, 7.46)] and serum folate [0.29 (0.18, 0.40)] was found. After multiple adjustments, age was still a positive predictor of serum folate [0.25 (0.14, 0.36)], whereas no significant influence on serum cobalamin was found [2.73 (-0.23, 5.69)]. Similar results were noticed when the analyses were restricted to non-users of B-vitamin/multi-vitamin supplements. In conclusion, the present study in community-dwelling subjects does not confirm age-related declines in serum concentrations of cobalamin and folate between the ages of 60 and 90 years. Although a significant proportion of the subjects showed dietary intake levels below the current European references values, serum concentrations of cobalamin and folate were predominantly in reference ranges. Longitudinal investigations on other biomarkers of cobalamin and folate status are warranted.
Intentional weight loss as a predictor of type 2 diabetes occurrence in a general population
Authors: Sares-Jäske Laura , Knekt Paul , Eranti Antti , Männistö Satu , Lindfors Olavi , Heliövaara Markku
Published: June 2020

Obesity is a major risk factor of type 2 diabetes (T2D). Accordingly, weight loss is being used to reduce this risk. Intervention studies have shown a T2D risk reduction due to weight loss in populations with an elevated risk. Data on the prediction of intentional weight loss (IWL) on diabetes occurrence at population level is, however, sparse. Since in observational studies IWL has been shown to predict later weight gain, possibly leading to adverse consequences, this study examined the prediction of IWL on T2D occurrence in a general population. Data from the representative Finnish Health 2000 Survey conducted in 2000–2001 was used. The study sample consisted of 1962 men and 2308 women, aged 30–69. Information on IWL during the previous year was collected with a questionnaire. Data for the covariates was collected with a health examination, interviews and questionnaires. Incident T2D cases during a 15-year follow-up were drawn from national health registers covering information on medication use, hospitalization, and cause of death. The Cox model was used to estimate strength of association between IWL and T2D occurrence. During the follow-up, 417 individuals developed a T2D. After adjusting for socio-demographic and lifestyle factors and the components of metabolic syndrome, IWL predicted an increased risk of T2D occurrence (HR 1.44; 95% CI 1.11–1.87) compared to individuals without IWL. Moreover, in interaction analyses, the risk in individuals with IWL compared to those without IWL was pronounced in younger age group and in those with the lowest quality diet. Furthermore, an elevated risk was consistently found in persons with IWL and overweight (BMI ≥ 25 kg/m2), also in combination with different aspects of poor health (i.e. mental health, self-perceived health, metabolic health). In the present cohort, IWL predicted an increased subsequent risk of developing T2D. This may be due to that in long-term at population level IWL causes an elevated risk of T2D e.g. by acting as a promotor for weight gain or by causing weight cycling resulting in unfavorable changes in metabolic health indicators. Alternatively, it cannot be excluded, that individuals reporting IWL already are at a greater risk of T2D and pursue IWL in response to that. Greater emphasis should be put on the initial prevention of weight gain and on the support on the weight maintenance after weight loss. Further cohort studies with repeated measurements on dieting behavior and changes in weight are needed.
Evaluating individual differences in a food based approach to increase egg and protein intake in older adults.
Authors: Heuvel Emmy van den , Murphy Jane L. , Appleton Katherine M
Published: June 2020

A randomized controlled intervention study was undertaken to increase egg and protein intake in community-dwelling adults over 55 years old. During a 12 week intervention, recipes for protein-rich egg-based meals and single-use herbs/spice packets were provided to 53 individuals in the intervention group to promote the addition of flavour and variety to the diet. Egg intakes increased by 20%, and this increase was sustained up to 12 weeks after the end of the intervention. Exploratory analyses however revealed some individual differences within the intervention group, where some participants increased their egg intake and others did not.

We compared the participants who increased their egg intake to those who did not on several demographic characteristics and baseline outcomes, and explored the qualitative feedback related to recipe use collected after the intervention.

Results show that the participants who increased their egg intake during the intervention (n = 27) had a significantly higher BMI (U = 402, p = .035), a lower health-related quality of life (U = 198, p = .047), and take external reports and recommendations about eggs and health from media and health professionals more seriously (U = 399, p = .038) than those who did not increase egg intake. Those who increased their egg intake during the 12 week follow up period (n = 19) reported a lower availability of eggs during their upbringing (U = 371, p = .041), with no other differences between the groups.

Feedback from the whole group showed that reasons for choosing to use or not use the recipes were based on preferences, culinary skills, time/effort to prepare the meal, having ingredients already in the cupboard, the importance of variety, habits and familiarity, and the portion sizes, which were generally considered too large. The recipes used most often included ingredients that are more traditionally combined with eggs in the English diet (e.g. cheese/ham), while the recipes used least often were more unfamiliar (e.g. Turkish eggs with yoghurt).

Our study used recipes that specifically focus on eggs, but our findings suggest that recipe based interventions in this age group may be particularly beneficial for those with a higher BMI, those who may feel their health could be improved, those who are more likely to respect external advice, and those who have less early experience with the included foods. Greater future benefit may also be obtained from recipes that are for smaller dishes, using familiar ingredients, and that cater to a range of culinary skills and preferences.
Review of the Nutrition Guidance Irish Healthcare and Charitable Organisations and Cancer Centres provide for Cancer Patients and Cancer Survivors.
Authors: Keaver Laura , Walsh Leah , Callaghan Helen , Houlihan Christine
Published: June 2020

Background: A cancer diagnosis presents a potential teachable moment however, evidence-based information, guidance and support all need to be available in order to capitalise on this. Health care professionals report providing little advice in this area. Previous work has shown that cancer survivors tend to prefer statutory and recognised charitable centres and groups. It is therefore important to determine what nutrition information is available on these websites as otherwise this group may turn to less reliable sources of information

Objective: To determine the availability, quality and readability of nutrition information for cancer patients and survivors from Irish healthcare organisations, cancer charity and support groups

Methods: Organisations were located using three search strategies: 1) We first sought to identify any nutrition information for cancer patients or survivors provided by the Irish Health Service Executive (HSE), 2) To identify suitable organisations the word “cancer” was searched for in the search engine of the Benefacts (official register of charitable organisations) website. The ten largest organisations were included and 3) an additional internet search was conducted using the terms ‘cancer charities Ireland’ and ‘cancer support groups Ireland’. The first two pages of results were assessed. The quality of the nutrition information was determined using the adapted IPDAS tool. Readability testing was carried out on the websites where nutrition information was available using

Results: A total of 32 websites were assessed. Of these only five provided any form of nutrition guidance for cancer patients with three of these five also providing some guidance for cancer survivors. The guidance provided centred on guidelines and lacked practical strategies for their implementation. The quality of the information provided ranged from 19.5–29 out of a maximum of 40. The readability level required to understand the information ranged from 11–17 years of age.

Conclusion: There is a need for nutritional guidance to be provided by national health and cancer related organisations and for this information to be specific to the cohort e.g. patient vs survivor. There is also a need for practical strategies to make the translation of guidelines into practice easy for patients and survivors.
Brain macroautophagy on the ketogenic diet
Authors: Liśkiewicz Daniela , Liskiewicz Arkadiusz , Nowacka-Chmielewska Marta , Student Sebastian , Anna Sługocka , Konstancja Jabłonska , Przybyła Marta , Jerzy Barski Jarosław , Małecki Andrzej
Published: June 2020

The ketogenic diet has been shown to be very effective in managing drug-resistant epilepsy, treatment of obesity, improving symptoms of diabetes and reducing cardiovascular risk. Growing evidence supports the use of the ketogenic diet as an alternative or additional therapy in many types of cancer, polycystic ovary syndrome, acne, and neurological diseases. The rationale for the use of the ketogenic diet in brain diseases is based on its neuroprotective properties. But mechanisms responsible for these effects are only partially explained. It is possible that stimulation of macroautophagy (hereafter termed autophagy) may be one of the mediators of the neuroprotection afforded by the ketogenic diet. Autophagy is a key mechanism for maintaining cell homeostasis and therefore its proper function is necessary for preventing accelerated brain aging and neurodegeneration. Autophagy has become a subject of intensive research as a promising target for neuroprotective strategies, which are urgently needed in our aging population, in which the burden of age-related diseases is constantly increasing. The ketogenic diet may induce autophagy in brain cells through at least a couple of mechanisms: downregulation of mTORC1, activation of AMP-activated kinase, elevation of free fatty acids, activation of Sirtuin 1 and an increase of HIF1α expression. The aim of this study was to verify the hypothesis that the ketogenic diet affects the level of autophagy in the mouse brain. Thirty 9-weeks-old male mice were divided into three groups and fed with one of two differently composed ketogenic chows (KA, KB) or with standard rodent chow (SD) for 4 subsequent weeks. Western blotting (LC3, p62) and confocal microscopy (LC3 puncta) were employed to monitor autophagy in hippocampal and cerebrocortical samples. The Western blot results revealed an increased level of LC3 II protein - a marker of autophagosomes, in the hippocampus and frontal cortex of mice treated with ketogenic diet. The size of this effect was dependent on the composition of the diet. This observation was confirmed by the evaluation of the number of LC3 puncta with immunofluorescence microscopy. This study reports for the first time the upregulation of autophagosome synthesis in the brain of animals fed with the ketogenic diet. Our results make a significant contribution to the understanding of the mechanisms of ketogenic diet action. This research is supported by the National Science Center grant no 2017/01/X/NZ3/00984.
Orange juice combined to a healthy-eating pattern improved endothelial function and reduced global risk of CHD in metabolic syndrome patients
Authors: Cesar Thais , Benassi Renata , Ponce Olivia , Nasser Michel
Published: June 2020

Current evidence has shown that orange juice flavonoids have antihypertensive, lipid lowering, insulin sensitizing, antioxidant and antinflammatory properties, which are correlated with antiatherogenic activity. The objective of this study was to verify whether regular administration of 100% pure orange juice (OJ), as a source of antioxidant and bioactive compounds, associated with a healthy dietary pattern improves endothelial and vascular function and reduces Global Risk of Coronary Heart Disease (Global Risk of CHD). Obese volunteers (n = 68) with metabolic syndrome were randomly assigned to the control (n = 34) or OJ (n = 34) groups, and all of them were counseled and followed up to maintain a healthy-eating pattern for 12 weeks. In addition, OJ group participants drank 500 ml of 100% orange juice daily in two servings of 250 mL each between meals. After the intervention, a significant reduction of 2% in anthropometric measurements (body weight and fat) was observed in both groups, with no change in lean mass. In the OJ group, a significant reduction of total cholesterol (-9.4%) was detected, whereas the controls reduced only HDL-C (-9%). In both groups there was a significant reduction in systolic and diastolic blood pressure (-8% and -9%, respectively) and an increase in antioxidant capacity (1%). Only the OJ group reduced vascular markers ICAM (-14%) and VCAM (-15%) and inflammatory markers TNF-alpha (-20%) and hsPCR (-22%) (p < 0.05). Both groups reduced IL-6 (-45%), improved brachial artery flow-mediated dilatation (BA-FMD), and reduced carotid artery intima-media thickness (CA-IMT) by 10% (p < 0.05). Daily consumption of orange juice, along with a healthy-eating pattern, was able to reduce cardiovascular risk factors related to systemic inflammation and endothelial function in individuals with metabolic syndrome. A significant reduction in the prevalence of the high-risk of CHD was observed in 47% of subjects who consumed a healthy diet, while 70% of patients who had a healthy eating pattern along with orange juice reverted to low CHD risk, showing the additional benefit of regular intake of 100% orange juice. This was probably due to the action of antioxidant compounds present in high concentrations in orange juice, such as vitamin C and citrus flavonoids
Effect of apple food matrix on plasma flavan-3-ols distribution and nutrigenomic profile in response to a nutritional challenge in minipigs
Authors: Monfoulet Laurent-Emmanuel , Buffiere Caroline , Istas Geoffrey , Dufour Claire , Bourvelec Carine le , Mercier Sylvie , Bayle Dominique , Boby Céline , Remond Didier , Borel Patrick , Rodriguez-Mateos Ana , Milenkovic Dragan , Morand Christine
Published: June 2020

Food matrix is known to interact with some dietary constituents and microconstituents during digestion. These interactions may potentially affect the metabolism and bioavailability of some compounds, and as a consequence modulate their biological effects. In this context, the aim of this study was to determine the effect of apple food matrix on the bioavailability of flavan-3-ols and on the ability of these compounds to modulate the nutrigenomic response to a high fat challenge in minipigs.

Adult male Yucatan minipigs (n = 5) were assigned to a random treatment sequence of high-fat meals non supplemented or supplemented with 250 g of raw apple, 250 g of apple puree or 1.4 g of apple polyphenols extract, with a 7-days washout period between each treatment. Each supplementation provided 155 mg flavan-3-ol monomers. At each treatment period, fasting- and 1h-, 2h-, 3h-postprandial blood samples were collected, and the concentration in flavan-3-ol monomers was measured on hydrolyzed serum, using UPLC-Q-TOF MS. The ability of apple-derived products to modulate the postprandial gene expression profile was assessed and compared in circulating PBMCs collected at 3 h after consumption of the four tested meals using a microarray analysis.

Results show that the apple matrix did not affect the kinetic of the postprandial absorption of flavan-3-ol monomers. The total flavan-3-ols concentrations measured at peak were significantly higher in the extract (x1.75), suggesting an impact of the apple matrix on flavan-3-ols absorption. However, no significant difference in total flavanols was observed between raw apple and apple puree.

Principal Component Analysis of the microarray data from PBMCs identified three distinct clusters of gene expression patterns: one corresponding to gene expression profiles after the high-fat meal, one for meal supplemented with raw apples or apple puree, and a third cluster for meal supplemented with polyphenol extract. A set of 309 genes was identified as differentially expressed by apple-derived products compared to high-fat meal alone, including 93 modulated with the three apple products. The variations in gene expression were similar for only 75% of the 93 genes, suggesting that the apple matrix affects the nutrigenomic response to flavan-3-ols. A bioinformatics analysis revealed that genes affected by apple-derived products are involved in inflammation and leukocyte transendothelial migration, suggesting a beneficial impact of apple-derived products.

In conclusion, these results raise awareness for considering the impact of food matrix on the biological responsiveness of polyphenols in future nutritional studies.
Food and Nutrient Intake over the Course of the Menstrual Cycle - Cycles Iceland
Authors: Birgisdóttir Bryndis Eva , Gunnlaugsson Geir , Vitzhum Virginia
Published: June 2020

Introduction:

In Iceland there are extreme seasonal differences in natural light. How these might affect the physiology of young women is largely unknown and prompted The Cycles-Iceland study. Both seasonal differences and the menstrual cycle have been suggested to affect womeńs food consumption and therefore nutrient intake. The aim of this part of the Cycles-Iceland study was to investigate food consumption and nutrient intake at different time points of the year and over the menstrual cycle.

Materials and methods:

In total 23 young women, mean (SD) age 31.6 (5.5) years, gave six 24-h dietary recalls each. These were given at the start, middle and at the end of one menstrual cycle, in both summer and winter seasons. The women were asked about various background factors while other lifestyle habits were also measured such as physical activity and sleep and light exposure. The women also gave biological samples, blood spots, urine and saliva for evaluation of hormonal and immune biomarkers.

Results:

The group scored above average on a healthy diet evaluation, based on the Icelandic Food Based Dietary Guidelines. First crude results indicate difference in choice of certain food items and therefore nutrient intake ex. sugar (p < 0.001) and fiber intake (p < 0.010), depending on the position in menstrual cycle. Difference in food choices were also seen between winter and summer time (p < 0.04).

Discussion:

Food and nutrient intake seems to be affected by the position of women in their menstrual cycle. Whether this might be related to hormonal status, inflammatory factors and other lifestyle factors needs further investigation. The results from Cycles-Iceland will contribute to better understanding of metabolic and health effects of natural seasonal cycles in the northern hemisphere.
Yeast beta-Glucan effects on gut microbiota for regulating insulin signaling system on alzheimer's disease
Authors: Mengdai Xu , Xiaoxing Mo , Hao Huang , Liegang Liu , Wei Yang
Published: June 2020

Introduction:

Alzheimer's disease (AD) is a progressive neurodegenerative disease for dementia in adults. The main pathological alterations are extracellular senile plaque deposits, intracellular neurofibrillary tangles and neuronal apoptosis. Recent researches indicated that T2D is closely with AD by insulin resistance in central nerves system progression. Nevertheless, the pathological mechanism remains unclear and treatment is limited. β-glucan extracted from yeast, as a dietary fiber with high bioactivity, edible, good taste and easy-obtainable, have been showed abilities such as anti-diabetic, anti-inflammatory and prebiotic. Based on this, β-glucan can reduce insulin resistance and maintain gut microbiota thereby alleviating lesions of early AD.

Materials and Methods:

In this study, we used 36 male wild-type C57BL/6J mice were divided to 3 groups (control (C) mice injected i.c.v. with 0.9% saline as a vehicle, mice injected i.c.v. with Aβ1–42 (Aβ1–42 group), mice injected with Aβ1–42 and soluble yeast β-glucan 100 mg/kg body weight by oral gavage daily (o.g.) for 5 wks (Aβ1–42 + Glu)). H&E method was detected for structure of hippocampus. Morris water maze test was performed to assess the cognitive performance of Aβ-infusion mice. The microbiota composition was analyzed by 16sRNA sequencing. The levels of inflammatory were measured in hippocampal and plasma by Meso-scale Discovery (MSD). Western blot was performed to detect the level of protein in insulin signaling pathway. One-way ANNOVA with Student-Newman-Keuls was applied for the data analysis through SPSS software version 22.0.

Results:

As demonstrated by H&E sections, β-glucan reduced neuron damage in AD mice hippocampus. Decreased the levels of Aβ and phosphorylation of Tau protein expression in hippocampus (P < 0.05) and ameliorated insulin resistance (p-IRS-1) in hippocampus (P < 0.05). According by results from MSD and Western-blot that showed TNF-α (P < 0.05), phosphorylated JNK (P < 0.01) and Tau were up-regulated in AD but β-glucan group decreased. In addition, the abundance of beneficial bacteria in β-glucan mice is increased (g_Alistipes, g_Rikeenella and g_Saccharibecteria genera incerae sedies).

Discussion:

Summary, this study illustrated that β-glucan regulated insulin signaling for ameliorating learning and memory deficit in AD. Due to β-glucan can not pass Blood-Brain-Barrier, we hypothesized that β-glucan could regulates gut microbiota by metabolites for ameliorating neuron damage. Our study provides new ideas for the prevention of AD.