Publicaciones H&NS

Drewnowski, A., Gonzalez, T. D., Rehm, C. D. (2022). Balanced hybrid nutrient density score compared to Nutri-Score and Health star rating receiver operating characteristic curve analyses. Frontiers in Nutrition. 9:867096, doi: 10.3389/fnut.2022.867096

Abstract:

Background: Nutrient profiling (NP) models that are used to assess the nutrient density of foods can be based on a combination of key nutrients and desirable food groups. Objective: To compare the diagnostic accuracy of a new balanced hybrid nutrient density score (bHNDS) to Nutri-Score and Health Star Rating (HSR) front-of-pack systems using receiver operating characteristic (ROC) curve analyses. The diet-level bHNDS was first validated against Healthy Eating Index (HEI-2015) using data from the 2017–18 National Health and Nutrition Examination Survey (2017–18 NHANES). Food-level bHNDS values were then compared to both the Nutri-Score and HSR using ROC curve analyses. Results: The bHNDS was based on 6 nutrients to encourage (protein, fiber, calcium, iron, potassium, and vitamin D); 5 food groups to encourage (whole grains, nuts and seeds, dairy, vegetables, and fruit), and 3 nutrients (saturated fat, added sugar, and sodium) to limit. The algorithm balanced components to encourage against those to limit. Diet-level bHNDS values correlated well with HEI-2015 (r = 0.67; p < 0.001). Food-level correlations with both Nutri-Score (r = 0.60) and with HSR (r = 0.58) were significant (both p < 0.001). ROC estimates of the Area Under the Curve (AUC) showed high agreement between bHNDS values and optimal Nutri-Score and HSR ratings (>0.90 in most cases). ROC analysis identified those bHNDS cut-off points that were predictive of A-grade Nutri-Score or 5-star HSR. Those cut-off points were highly category-specific. Conclusion: The new bHNDS model showed high agreement with two front-of-pack labeling systems. Cross-model comparisons based on ROC curve analyses are the first step toward harmonization of proliferating NP methods that aim to “diagnose” high nutrient-density foods.

Wolever, T. M.S., Jenkins, A., L., Campbell, J. E., Ezatagha A., . . . Chu, Y. (2022). Decreasing the RAG: SAG ratio of granola cereal predictably reduces postprandial glucose and insulin responses: a report of four randomised trials in healthy adults. Journal of Nutritional Science. 11(1-12). doi:10.1017/jns.2022.22

Abstract:

Dietary starch contains rapidly (RAG) and slowly available glucose (SAG). To establish the relationships between the RAG:SAG ratio and postprandial glucose, insulin and hunger, we measured postprandial responses elicited by test meals varying in the RAG:SAG ratio in n 160 healthy adults, each of whom participated in one of four randomised cross-over studies (n 40 each): a pilot trial comparing six chews (RAG:SAG ratio 2·4–42·7) and three studies comparing a test granola (TG1-3, RAG:SAG ratio 4·5–5·2) with a control granola (CG1–3, RAG:SAG ratio 54·8–69·3). Within studies, test meals were matched for fat, protein and available carbohydrate. Blood glucose, serum insulin and subjective hunger were measured for 3 h. Data were subjected to repeated-measures analysis of variance (ANOVA). The relationships between the RAG:SAG ratio and postprandial end points were determined by regression analysis. In the pilot trial, 0–2 h glucose incremental areas under the curve (iAUC0–2; primary end point) varied across the six chews (P = 0·014) with each 50 % reduction in the RAG:SAG ratio reducing relative glucose response by 4·0 %. TGs1-3 elicited significantly lower glucose iAUC0–2 than CGs1–3 by 17, 18 and 17 %, respectively (similar to the 15 % reduction predicted by the pilot trial). The combined means ± SEM (n 120) for TC and CG were glucose iAUC0–2, 98 ± 4 v. 118 ± 4 mmol × min/l (P < 0·001), and insulin iAUC0–2, 153 ± 9 v. 184 ± 11 nmol × h/l (P < 0·001), respectively. Neither postprandial hunger nor glucose or hunger increments 2 h after eating differed significantly between TG and CG. We concluded that TGs with RAG:SAG ratios <5·5 predictably reduced glycaemic and insulinaemic responses compared with CGs with RAG:SAG ratios >54. However, compared with CG, TG did not reduce postprandial hunger or delay the return of glucose or hunger to baseline.

Dicklin, M. R., Barron, R., Goltz, S., Warren, J., . . .Maki, K.C. (2022). Fiber and micronutrient intakes among fruit juice consumers and non-consumers in the United Kingdom and France: modeling the effects of consumption of an orange pomace juice product. Journal of Human Nutrition and Dietetics. 1-15. https://doi.org/10.1111/jhn.12995

Abstract:

Fruit intake, including consumption of 100% fruit juice, is generally associated with a better diet quality and overall health. However, fruit and vegetable intakes are below recommendations in many countries. Methods The present study examined fruit juice intake and total energy and nutrient intakes according to juice consumption or non-consumption in participants in the National Dietary and Nutrition Survey Rolling Programme 2014–2016 in the UK (n = 2723) and the Individual and National Study on Food Consumption 2006–2007 (n = 4079) in France. Total energy and nutrient intakes were also estimated for scenarios in which orange juice with pomace was either added to the daily diet or replaced 100% orange juice or beverages containing fruit juice. Results Fruit juice consumers had higher intakes of fruits and vegetables than non-consumers, were more likely to reach 5-a-day targets for fruit and vegetable consumption, and had significantly higher intakes of folate, vitamin C, potassium, magnesium, and fibre. Juice consumers also had higher total energy and sugar intakes, but lower body mass index than non-juice consumers. Modelling consumption of orange juice with pomace increased fibre and potassium intakes in orange juice consumers, and also increased fibre, most micronutrients, and 5-a-day achievements in non-juice consumers. Conclusions These national survey results demonstrate that fruit juice consumers in the UK and France had higher intakes of fruits and vegetables than fruit juice non-consumers, and significantly higher intakes of several micronutrients and fibre. Furthermore, modelling of consumption of orange juice with pomace increased fibre and select micronutrient intakes, particularly among fruit juice non-consumers.

Rao, E., S., Yadav, R., Rizwana, Lalmuanpuia, C., . . . Meena, P. M. (2022). Impact of Nutrition Education on Whole Grains Consumption amongst Primary and Middle School Children in Delhi. Food Science and Technology, 10(2),  23 – 33. doi: 10.13189/fst.2022.100202

Abstract:

Imparting nutrition education in schools is an effective tool for inculcating healthy eating behavior in early childhood, which will bestow lifelong positive health implications. Ignorance, illiteracy, lack of nutrition knowledge, and inappropriate nutritional practices and dietary traditions influence the nutritional status of children. This study assesses the existing knowledge, attitude, and practices prevalent amongst the school children (6-14 years) in the consumption of whole grains and examines the impact of nutritional intervention on them. 22% of participants were from primary school in the age group of 6-10 years, and 78% were from middle school between the ages of 11-14 years. Total percentage of girl students was 84% against boys, which was 16%. Nutrition education was imparted to the school children through visual presentation on the importance of consuming whole grains, structure and composition of whole grains, difference between refined and whole grains, food sources, nutritional importance, rich sources of dietary and soluble fibre, besides promoting digestive health and wellness. Self-designed fun nutrition games and food quizzes were employed to engage with the school students. In the pre-assessment survey, the middle school students showed significantly (p≤0.05) higher knowledge than primary school students. Although after implementing the nutrition education program in the post-assessment survey, an increase in knowledge about whole grains was observed both in primary as well as middle school students. However, no significant difference was seen in the knowledge acquisition between male and female students in pre or post-nutrition intervention assessment. The present study showed an incremental rise in the knowledge and attitude of primary and secondary school children in the age group of 6-14 years in all aspects of whole-grain education. Therefore, this intervention showed that in order to bridge the gap of nutrition literacy among school-going children, integrating nutrition education into the school curriculum can be an effective tool for inculcating healthy eating behavior in early childhood.

Roark, E.K., Rehm, C.D., Sherry, C.L. (2022). Potential for Front of Pack Labeling Exposure to Impact US Dietary Choices: A Population-Based Cross-Sectional Study Using NHANES 2017–2018. Nutrients. 14(14):2995. doi.org/10.3390/nu14142995 

Abstract

In recent years, front-of-pack nutrition labeling (FOPL) schemes have proliferated, but the components of the diet subject to FOPL have not been described. This study quantified the proportion and elements of the diet that would be subject to FOPL in the US. The 2017–2018 National Health and Nutrition Examination Survey (n = 7121; age ≥2 year) 24-h dietary recalls were used to identify foods/beverages subject to FOPL. The proportion of dietary energy and additional dietary constituents subject to FOPL was estimated. Overall, 57% of dietary energy would be subject to FOPL. Individuals consuming more away-from-home meals had lower exposure to FOPL. Adults with a healthy-weight and those consuming a more healthful diet had more exposure to FOPL. Protein, sodium, potassium, whole fruit, vegetables, and unprocessed meats were less subject to FOPL as compared to total sugars, added sugars, calcium, fruit juice, milk, yogurt, nuts/seeds and whole grains. Because less than 60% of the diet would be impacted by FOPL, implementation of such a policy may have limited reach for the US diet and demonstrates some inconsistencies with current dietary guidance regarding the under- and over-representation of key food groups and nutrients.

Noronha, J. C., Zurbau, A., Wolever, T., M., S. (2022). The importance of molecular weight in determining the minimum dose of oat β-glucan required to reduce the glycemic response in healthy subjects without diabetes: a systematic review and meta-regression analysis. European Journal of Clinical Nutrition. doi.org/10.1038/s41430-022-01176-5

Abstract:

To determine the minimum amount of oat β-glucan (OBG) required to reduce glycaemic responses (MinDose), we conducted a systematic review and meta-regression analysis of acute, crossover, single-meal feeding trials that examined the effects of adding OBG or oat bran to a carbohydrate-containing test-meal versus a control test-meal containing an equivalent amount of available-carbohydrate (avCHO) from the same or similar source. Medline, Embase, and Cochrane Library were searched up to 18 August 2021. The primary outcome was glucose incremental-area-under-the-curve (iAUC). Secondary outcomes included insulin iAUC, and glucose and insulin incremental peak-rise (iPeak). Two independent reviewers extracted data. Results were expressed as ratio-of-means (RoM) with 95% confidence intervals (CIs). Linear associations were assessed by random effects meta-regression. MinDose was defined as the dose at which the upper 95% CI of the regression line cut the line of no effect (i.e., RoM = 1). Fifty-nine comparisons (n = 340) were included; 57 in healthy subjects without diabetes and two in subjects with diabetes; 24 high-MW (>1000 kg/mol), 22 medium-MW (300–1,000 kg/mol), and 13 low-MW (<300 kg/mol). In healthy subjects without diabetes the associations between OBG dose and glucose iAUC and iPeak were linear (non-linear p value >0.05). MinDoses for glucose iAUC for high-MW, medium-MW and low-MW OBG, respectively, were estimated to be 0.2 g, 2.2 g and 3.2 g per 30 g avCHO; MinDoses for glucose iPeak were less than those for iAUC. Insufficient data were available to assess MinDose for insulin, however, there was no evidence of a disproportionate increase in insulin. More high-quality trials are needed to establish MinDose in individuals with diabetes.

Greenberg, D., Drewnowski, A., Black, R., Weststrate, J. A., O'Shea, M. (2021). A progressive nutrient profiling system to guide improvements in nutrient density of foods and beverages. Frontiers in Nutrition, 8, doi:10.3389/fnut.2021.774409  

Abstract:

Improving the nutrient density of processed foods is one way to bring the global food supply closer to the WHO Sustainable Development Goals. Nutrient profiling (NP) has emerged as the preferred method of monitoring the progress toward product innovation and reformulation. This paper presents PepsiCo Nutrition Criteria (PNC), a new internal NP model that was designed to guide and monitor improvements in nutrient density and overall nutritional quality of foods and beverages. The new PNC NP model assigns food products into four classes of increasing nutritional value, based on the content of nutrients to limit, along with nutrients and ingredients to encourage. The nutrient standards used for category assignment followed those developed by global dietary authorities. Standards are proposed for calories, sodium, added sugars, saturated, and industrially produced trans fats. Also included are minimum values for food groups to encourage, low-fat dairy, and for country-specific gap nutrients. Internal use of the NP model has spurred product changes that are consistent with WHO goals for industry transparency. An audited review of company products showed that 48% met added sugar, 65% met sodium, and 71% met saturated fat goals. By the end of 2020, in the top 26 regions in which products are sold, 48% of the total sales volume of global beverages had 100 kcal or less from added sugars per 355 ml serving representing 80% of beverage volume and over 90% of food volume sold globally. The PNC NP model is not consumer-facing but is specifically intended for internal use to motivate stepwise and incremental product innovation and reformulation. Transparent and published NP models further WHO goals of engaging industry stakeholders in the (re)formulation of processed foods and beverages consistent with public health goals.

Musa-Veloso, K., Noori, D., Venditti, C., Poon, T., . . . Chu, Y. (2021). A systematic review and meta-analysis of randomized controlled trials on the effects of oats and oat processing on postprandial blood glucose and insulin responses. The Journal of Nutrition, 151(2), 341-351. doi:10.1093/jn/nxaa349

Abstract:

Background

Oats are a whole grain cereal with potentially favorable effects on the postprandial glycemic response; however, the effects of oat processing on these glycemic benefits are not well understood.

Objectives

The study objective was to determine the effects of differently processed oats on the postprandial blood glucose and insulin responses relative to refined grains.

Methods

Eleven electronic databases were systematically searched to identify studies published up to and including May 2019. Randomized controlled trials comparing the postprandial blood glucose and insulin responses to oats compared with any refined grain were included, so long as the available carbohydrate content of the test meals was similar. Pooled effect sizes were computed using the difference in incremental area under the curves for blood glucose and insulin following the consumption of oats compared with the refined grain control.

Results

Ten publications were included, with intact oat kernels studied in 3 comparisons, thick oat flakes (>0.6 mm) in 7 comparisons, and thin/quick/instant oat flakes (≤0.6 mm) in 6 comparisons. Compared with the consumption of the refined grain control, the consumption of intact oat kernels was associated with significant reductions in postprandial blood glucose (−45.5 mmol x min/L; 95% CI: −80.1, −10.9 mmol x min/L; P = 0.010) and insulin (−4.5 nmol x min/L; 95% CI: −7.1, −1.8 nmol x min/L; P = 0.001) responses; the consumption of thick oat flakes was associated with significant reductions in postprandial blood glucose (−30.6 mmol x min/L; 95% CI: −40.4, −20.9 mmol x min/L; P < 0.001) and insulin (−3.9 nmol x min/L; 95% CI: −5.3, −2.5 nmol x min/L; P < 0.001) responses; but, the consumption of thin/quick/instant oat flakes was not associated with any effects on the postprandial blood glucose and insulin responses.

Conclusions

A disruption in the structural integrity of the oat kernel is likely associated with a loss in the glycemic benefits of oats.

Jackson, P. A., Haskell-Ramsay, C., Forster, J., Khan, J., . . . Wightman, E. L. (2021). Acute cognitive performance and mood effects of coffee berry and apple extracts: A randomised, double blind, placebo controlled crossover study in healthy humans. Nutritional Neuroscience, 1-9. doi:10.1080/1028415X.2021.1963068

Abstract:

Background: Polyphenols from coffee berry (chlorogenic acid) and apple (flavanol) have been shown to improve mood and increase cerebral blood flow in healthy humans. These effects may underpin the cognitive effects of polyphenols seen previously. Objective: The aim of the present paper was to extend previous research by investigating the effects of coffee berry at high and low doses when combined with apple extract on cognitive performance and mood. Design: This randomised, double-blind, placebo controlled, crossover trial included 46 healthy males and females,18–49 years of age (mean age 23 years),consuming: 1100 mg coffee berry extract, 1100 mg coffee berry extract plus 275 mg apple extract, 100 mg coffee berry extract plus 275 mg apple extract or placebo on 4 separate occasions, completing cognitive and mood assessments pre-dose and then again at 1-, 3- and 6 hrs post-dose. Results: Analysis revealed a consistent pattern of alerting effects following 1100 mg coffee berry extract. Limited effects on cognitive function were observed. Specifically, faster peg and ball performance (executive function) was observed following 1100 mg coffee berry plus apple extract and accuracy on the Rapid Visual Information Processing (RVIP) task increased on the third of four repetitions following 1100 mg coffee berry alone. Interestingly, more false alarms on RVIP were observed following the same intervention. Conclusions: In line with previous findings, 1100 mg coffee berry engendered increased arousal. The absence of effects on mood when an apple extract was added, and the potential for the low dose of caffeine within the coffee berry to act synergistically with polyphenols, raise interesting future avenues of research.

Guzman, G., Xiao, D., Liska, D., Mah, E., . . . Edirisinghe, I. (2021). Addition of orange pomace attenuates the acute glycemic response to orange juice in healthy adults. The Journal of Nutrition, nxab017. doi:10.1093/jn/nxab017

Abstract:

Background Fiber is an important part of a healthy diet and is known to attenuate postprandial glycemia. Orange pomace (OP) is a by-product of orange juice (OJ) production and is a rich source of fiber. Objective Two separate studies determined the impact of added OP to 100% OJ on postprandial glycemic response compared with sugar-matched OJ or whole orange fruit (WOF). Methods Study 1 included 17 adults [65% female, age 39.3 ± 3.1 y, and BMI (in kg/m²) 24.6 ± 0.7], and study 2 included 45 different adults (47% female, age 25.1 ± 4.3 y, and BMI 22.5 ± 1.6). Studies were conducted at separate locations using a randomized, 3-arm, crossover design to test the glycemic response to sugar-matched OJ, OJ with 5 g fiber from OP (OPF), or WOF. The primary outcomes were 2-h glucose incremental area under the curve (iAUC) in study 1, analyzed by repeated measures ANOVA, and maximum glucose concentration (C_max) in study 2, analyzed using PROC MIXED (ANCOVA). Glucose and insulin concentrations were measured at fasting and multiple time points over 2 h after test product consumption (study 1, serum; study 2, plasma). Results In study 1, glucose iAUC was not significantly lower in OPF compared to the OJ or WOF (825 ± 132 compared with 920 ± 132 and 760 ± 132 mg · min · dL⁻¹, respectively, P = 0.57 for both). In study 2, glucose iAUC was significantly lower in WOF compared with OPF and OJ (689 ± 70.7 compared with 892 ± 70.7 and 974 ± 70.7 mg · min · dL⁻¹, P = 0.02 and 0.001, respectively). Data from both studies indicated OPF reduced C_max compared with OJ and that the reductions were comparable to WOF (study 1: OPF, 115 ± 4.06 compared with OJ, 124 ± 4.06 and WOF, 114 ± 4.06 mg · dL⁻¹, P = 0.002 and 0.75, respectively; study 2: OPF, 128 ± 1.92 compared with OJ, 136 ± 1.92 and WOF, 125 ± 1.92 mg · dL⁻¹, P = 0.001 and 0.28, respectively). Conclusion Data from both studies demonstrated no significant effect of OPF on postprandial iAUC compared with OJ. However, adding OP into OJ attenuates the postprandial glucose C_max, and the responses were comparable to WOF in healthy adults.

Ward-Ritacco, C. L., Wilson, A. R. & O’Connor, P. J. (2021). An apple extract beverage combined with caffeine can improve alertness, mental fatigue, and information processing speed. Journal of Cognitive Enhancement. doi:10.1007/s41465-020-00204-1

Abstract:

The psychological effects of low-dose caffeine combined with polyphenols from apples have rarely been explored scientifically yet synergistic effects are plausible. A randomized, double-blind, placebo-controlled cross-over experiment was used to test the psychological effects of apple extract beverages combined with 10, 20, 37.5, and 75 mg caffeine. Comparisons were made to both a placebo drink that was artificially sweetened and colored to mimic the test beverages and a positive control drink with 75 mg caffeine but without apple extract. Compared to placebo, it was hypothesized that dose-dependent improvements in cognitive performance, mood, and motivation would be realized after consuming the beverage with apple extract containing added caffeine. Outcomes were assessed before, 60 to 110, and 125 to 175 min post-beverage. The positive control beverage resulted in more serial seven subtractions, greater motivation to perform cognitive tasks, and reduced feelings of fatigue (all p < .005). The study found that psychological effects (i) were not observed for beverages containing apple extract and 10 or 20 mg caffeine, (ii) of the apple extract beverage containing 75 mg caffeine generally mimicked the effects of the positive control drink and significantly increased serial seven processing speed, and (iii) of the apple extract beverage containing 37.5 mg improved feelings of alertness and mental fatigue. In sum, effects of apple extract combined with caffeine were not dose-dependent; the apple extract beverage containing 75 mg caffeine improved information processing speed and the apple extract beverage with 37.5 mg caffeine improved feelings of alertness and mental fatigue.

Wolever, T. M. S., Rahn, M., Duom, E. H., Spruill, S. E., . . . Chu, Y. (2021). An oat β-glucan beverage reduces LDL cholesterol and cardiovascular disease risk in men and women with borderline high cholesterol: A double-blind, randomized, controlled clinical trial. The Journal of Nutrition. doi:10.1093/jn/nxab154

Abstract:

Background High-molecular-weight (MW) oat β-glucan (OBG), consumed at 3–4 g/d, in solid foods reduces LDL cholesterol by a median of ∼6.5%. Objectives We evaluated the effect of a beverage providing 3 g/d high-MW OBG on reduction of LDL cholesterol (primary endpoint) when compared with placebo. Methods We performed a parallel-design, randomized clinical trial at a contract research organization; participants, caregivers, and outcome assessors were blinded to treatment allocation. Participants with LDL cholesterol between 3.0 and 5.0 mmol/L, inclusive [n = 538 screened, n = 260 ineligible, n = 23 lost, n = 48 withdrawn (product safety); n = 207 randomly assigned, n = 7 dropped out, n = 9 withdrawn (protocol violation); n = 191 analyzed; n = 72 (37.7%) male, mean ± SD age: 43.3 ± 14.3 y, BMI: 29.7 ± 5.2 kg/m²], were randomly assigned to consume, 3 times daily for 4 wk, 1 g OBG (n = 104, n = 96 analyzed) or rice powder (Control, n = 103, n = 95 analyzed) mixed into 250 mL water. Treatment effects were assessed as change from baseline and differences analyzed using a 2-sided t test via ANOVA with baseline characteristics as covariates. Results After 4 wk, change from baseline least-squares-mean LDL cholesterol on OBG (−0.195 mmol/L) was less than on Control (0.012 mmol/L) by mean: 0.207 mmol/L (95% CI: 0.318, 0.096 mmol/L; P = 0.0003); the following secondary endpoints were also reduced as follows: total cholesterol (TC) (0.226 mmol/L; 95% CI: 0.361, 0.091 mmol/L; P = 0.001), TC:HDL cholesterol ratio (0.147; 95% CI: 0.284, 0.010; P = 0.036), non-HDL cholesterol (0.194 mmol/L; 95% CI: 0.314, 0.073 mmol/L; P = 0.002), and Framingham cardiovascular disease (CVD) risk (0.474; 95% CI: 0.900, 0.049, P = 0.029). Changes in HDL cholesterol, triglycerides, glucose, and insulin did not differ between treatment groups (P > 0.05). Lipid treatment effects were not significantly modified by age, sex, BMI, or hypertension treatment. There were no major adverse events, but both treatments transiently increased gastrointestinal symptoms. Conclusions Consuming a beverage containing 1 g high-MW OBG 3 times daily for 4 wk significantly reduced LDL cholesterol by ∼6% and CVD risk by ∼8% in healthy adults with LDL cholesterol between 3 and 5 mmol/L.

Brauchla, M., & Fulgoni, V. L. (2021). Cost-effective options for increasing consumption of under-consumed food groups and nutrients in the United States. Public Health Nutrition, 1-18. doi:10.1017/S1368980021000537

Abstract:

Objective: To identify the most cost-effective options/contributors of under-consumed food groups and nutrients in the USA. Design: Twenty-four-hour dietary recall data were used for the dietary sources of under-consumed food groups and nutrients. Costs were estimated using USDA National Food Price Database 2001–2004 after adjustments for inflation using Consumer Price Index. Setting: National Health and Nutrition Examination Survey, 2013–2016. Participants: A total of 10 112 adults aged 19+ years. Results: Top five cost-effective options for food groups were apple and citrus juice, bananas, apples, and melons for fruit; baked/boiled white potatoes, mixtures of mashed potatoes, lettuce, carrots and string beans for vegetables; oatmeal, popcorn, rice, yeast breads and pasta/noodles/cooked grains for whole grain; and reduced-fat, low-fat milk, flavoured milk and cheese for dairy. Top five cost-effective sources of under-consumed nutrients were rice, tortillas, pasta/noodles/cooked grains, rolls and buns, and peanut butter–jelly sandwiches for Mg; grits/cooked cereals, low- and high-sugar ready-to-eat (RTE) cereal, rolls and buns, and rice for Fe; low- and high-sugar RTE cereals, rice, protein and nutritional powders, and rolls and buns for Zn; carrots, margarine, other red and orange vegetables, liver and organ meats, butter and animal fats for vitamin A; and citrus juice, other fruit juice, vegetable juice, mustard and other condiments, and apple juice for vitamin C. Conclusions: Apple/citrus juice, white potatoes/carrots, oatmeal, RTE cereals and milk were the most cost-effective food sources of multiple under-consumed food groups and nutrients and can help promote healthy eating habits at minimal cost.

Madan, J., Blonquist, T., Rao, E., Marwaha, A., . . . Chen, O. (2021). Effect of COVID-19 pandemic-induced dietary and lifestyle changes and their associations with perceived health status and self-reported body weight changes in India: A cross-sectional survey. Nutrients, 13(11), 3682. doi:10.3390/nu13113682

Abstract:

Home confinement during the COVID-19 pandemic is accompanied by dramatic changes in lifestyle and dietary behaviors that can significantly influence health. We conducted an online cross-sectional survey to assess COVID-19 pandemic-induced dietary and lifestyle changes and their association with perceived health status and self-reported body weight changes among 1000 Indian adults in early 2021. Positive improvements in dietary habits, e.g., eating more nutritious (85% of participants) and home-cooked food (89%) and an increase in overall nutrition intake (79%), were observed. Sixty-five percent of participants self-reported increased oat consumption to support immunity. There were some negative changes, e.g., more binge eating (69%), eating more in between meals (67%), and increasing meal portion size (72%). Two-thirds of participants reported no change in lifestyles, whereas 21 and 23% reported an increase, and 13 and 10% reported a decrease in physical activity and sleep, respectively. Overall, 64 and 65% of participants reported an improvement in perceived health and an increase in body weight during the COVID-19 period compared to pre-COVID-19, respectively. The top motivations for improving dietary habits included improving physical and mental health and building immunity. In conclusion, the overall perceived health was improved and there was an increase in self-reported body weight in most participants during COVID-19. Diet emerged as the most crucial determinant for these changes.

Wolever, T. M. S., Rahn, M., Dioum, E. H., Jenkins, A. L., . . . Chu, Y. (2021). Effect of oat β-glucan on affective and physical feeling states in healthy adults: Evidence for reduced headache, fatigue, anxiety and limb/joint pains. Nutrients, 13(5), 1534. doi:10.3390/nu13051534

Abstract:

The gastrointestinal (GI) side-effects of dietary fibers are recognized, but less is known about their effects on non-GI symptoms. We assessed non-GI symptoms in a trial of the LDL-cholesterol lowering effect of oat β-glucan (OBG). Participants (n = 207) with borderline high LDL-cholesterol were randomized to an OBG (1 g OBG, n = 104, n = 96 analyzed) or Control (n = 103, n = 95 analyzed) beverage 3-times daily for 4 weeks. At screening, baseline, 2 weeks and 4 weeks participants rated the severity of 16 non-GI symptoms as none, mild, moderate or severe. The occurrence and severity (more or less severe than pre-treatment) were compared using chi-squared and Fisher’s exact test, respectively. During OBG treatment, the occurrence of exhaustion and fatigue decreased versus baseline (p < 0.05). The severity of headache (2 weeks, p = 0.032), anxiety (2 weeks p = 0.059) and feeling cold (4 weeks, p = 0.040) were less on OBG than Control. The severity of fatigue and hot flashes at 4 weeks, limb/joint pain at 2 weeks and difficulty concentrating at both times decreased on OBG versus baseline. High serum c-reactive-protein and changes in c-reactive-protein, oxidized-LDL, and GI-symptom severity were associated with the occurrence and severity of several non-GI symptoms. These data provide preliminary, hypothesis-generating evidence that OBG may reduce several non-GI symptoms in healthy adults.

Ames, N., Malunga, L. N., Mollard, R., Johnson, J., . . . Thandapilly, S. J. (2021). Effect of processing on oat β-glucan viscosity, postprandial glycemic response and subjective measures of appetite. Food & Function, 12(8), 3672–3679. doi:10.1039/d0fo03283b

Abstract:

Oat has procured its acclaim as a health promoting food partially due to its positive effect on glucose control. It has been demonstrated that oat β-glucan can interfere with postprandial glucose response. A large majority of this action is attributed to the increase in viscosity due to the β-glucan content in oat foods. While it is known that an increase in viscosity due to higher molecular weight of β-glucan can improve its glycemic effects, it is not known if an increase in viscosity attained by processing variables can further enhance the positive effect of oat on glucose control. In the current study we have examined the effect of kilning, tempering, microwaving, cooking, soaking and flaking on oat β-glucan viscosity. An acute randomized crossover clinical trial was also conducted to test oatmeal products containing low, medium and high β-glucan viscosity for their effect on postprandial glycemic response. Results from the processing experiments demonstrate that kilned samples, when tempered to 25% moisture and microwaved for 2 minutes, can produce much higher final viscosity compared to other samples with similar β-glucan content, molecular weight and solubility. However, results from the clinical trial show that the increase in the viscosity of the oat β-glucan attained through processing in this study did not have any effect on postprandial glucose control.

Bharti, R., Marwaha, A., Badshah, T., Sengupta, R., . . . Bhatia, B. Effectiveness of a nutritional education intervention focused on iron among school children in National Capital Region and Mumbai. Journal of Clinical and Diagnostic Research, 15(4), OC31-OC36. doi:10.7860/JCDR/2021/46024.14806 

Abstract:

Introduction: Anaemia is a major health problem in India. Various studies mention poor nutrition knowledge and education as main factors of malnutrition. Aim: This study aims at assessing the effect of nutritional education on iron among school children. Materials and Methods: A cross-sectional interventional study was undertaken to improve nutrition literacy in schools from April 2018 to February 2019. The outreach platform used was Eat Right School program by Food Safety and Standards Authority of India (FSSAI). A study tool employed was data collection using self-developed questionnaire for pre and post-intervention knowledge assessment. School children from Delhi NCR and Mumbai participated in this study. Knowledge intervention was done on 5 key elements related to iron including role, sources, iron deficiency anaemia, iron absorption and knowledge of fortification. Chi-square test was applied for comparison. Results: It was found that 54% (n=18,626) of school children studied were in the age group 11-14 years. From 27355 participants who reported the gender, 58.1% (n=15899) were males and 41.9% (n=11456) were females. Comparison of pre and post-intervention assessment revealed that percentage of students knowing importance/role of iron increased from 27.30% to 59.50%, iron deficiency anaemia from 34.03% to 59.85%, sources of iron from 25.20% to 51.70%, iron absorption from 36.00% to 61.2% and knowledge of fortification from 55.4% to 76.9%. Thus, significant shift (p≤0.001) in all the parameters was observed; improvement in scores ranged from 21.5% to 32.20% with highest increase seen in understanding the role of iron. Conclusion: Results of the study reject the null hypothesis leading to acceptance of alternate hypothesis. The alternate hypothesis highlights the role of nutrition education in improving the nutritional literacy of school children in the area of iron and iron deficiency anaemia. Results of the current study increased the knowledge of children on all parameters related to iron education module. Thus, nutritional literacy is imperative in improving nutritional status and adolescent age-group is the window of opportunity to correct it.

Kamil, A., Wilson, A. R., & Rehm, C. D. (2021). Estimated sweetness in US diet among children and adults declined from 2001 to 2018: A serial cross-sectional surveillance study using NHANES 2001–2018. Frontiers in Nutrition, 8, 1004. doi:10.3389/fnut.2021.777857 

Abstract:

An agreed-upon measure of total dietary sweetness is lacking hindering assessments of population-level patterns and trends in dietary sweetness. This cross-sectional study used 24-h dietary recall data for 74,461 participants aged ≥ 2 y from nine cycles (2001–2018) of the National Health and Nutrition Examination Survey (NHANES) to evaluate trends in the sweetness of the diet in the United States (US). LCS-containing items were matched to a sugar-sweetened counterpart (e.g., diet cola–regular cola or sucralose sugar). The matched pair was used to estimate the sugar equivalents from LCS-sweetened foods or beverages to estimate dietary level sweetness, which was described as grams of approximate sugar equivalent (ASE) per day. Trends in ASE were estimated overall and by subgroup, and trends were further disaggregated by food or beverage category. Overall, LCS sources contributed about 10.5% of ASE. Total ASE declined from 152 g/d to 117 g/d from 2001–2002 to 2017–2018 (p-trend < 0.001), with comparable declines in children and adults. Declines in total ASE were predominantly driven by beverages (−36.7% from 2001–2002 to 2017–2018) and tabletop sweeteners (−23.8%), but not food (−1.5%). Observed trends were robust to sensitivity analyses incorporating random, systematic, and sensory trial informed estimates of sweetness and also an analysis excluding possible under-reporters of dietary energy. This practical approach and underlying data may help researchers to apply the technique to other dietary studies to further these questions.

Van den Abbeele, P., Duysburgh, C., Ghyselinck, J., Goltz, S., . . . Marzorati, M. (2021). Fructans with varying degree of polymerization enhance the selective growth of bifidobacterium animalis subsp. lactis bb-12 in the human gut microbiome in vitro. Applied Sciences (Switzerland), 11(2), 1-19. doi:10.3390/app11020598

Abstract:

Synbiotics aim to improve gastrointestinal health by combining pre- and probiotics. This study evaluated combinations of Bifidobacterium animalis subsp. lactis BB-12 with seven fructans: oligofructoses (OF1-OF2; low degree of polymerization (DP)), inulins (IN1-IN2-IN3; high DP) and OF/IN mixtures (OF/IN1-OF/IN2). During monoculture incubations, all fructans were fermented by BB-12 as followed from increased BB-12 numbers and increased acetate and lactate concentrations, with most pronounced fermentation for low DP fructans (OF1-OF2). Further, short-term colonic incubations for three human donors revealed that also in presence of a complex microbiota, all fructans (particularly OF1) consistently selectively enhanced the growth of BB-12. While each fructan as such already increased Bifidobacteriaceae numbers with 0.94–1.26 log(cells/mL), BB-12 co-supplementation additionally increased Bifidobacteriaceae with 0.17–0.46 log(cells/mL). Further, when co-supplemented with fructans, BB-12 decreased Enterobacteriaceae numbers (significant except for IN1-IN3). At metabolic level, all fructans decreased pH due to increased acetate and lactate production, while OF/IN2-IN1-IN2-IN3 also stimulated propionate and butyrate production. BB-12 co-supplementation further increased propionate and butyrate for OF/IN2-IN3 and IN1-IN2, respectively. Overall, combinations of BB-12 with fructans are promising synbiotic concepts, likely due to intracellular consumption of low DP-fructans by BB-12 (either present in starting product or released upon fermentation by indigenous microbes), thereby enhancing effects of the co-administered fructan.

Horodyska, J., Pigat, S., Wonik, J., Bompola, F., . . . Gonzalez, T. D. (2021). Impact of sociodemographic factors on the consumption of tubers in Brazil. Nutrition Journal, 20, 54. doi:10.1186/s12937-021-00709-1

Abstract:

Background Although tubers play a significant role in Brazilian agriculture, very little is known about the intake of tubers among the Brazilian population. The objective of this study was to characterize the intake of tubers across Brazil. The types of tubers consumed were quantified, and the impact of geographic and sociodemographic factors was assessed. Methods This cross-sectional study is based on dietary intake data of 33,504 subjects obtained from the Brazilian National Dietary Survey. All tuber containing foods were identified, and the contribution of different tubers to overall tuber consumption in Brazil was quantified. Descriptive analyses assessed the impact of macroregion and sociodemographic characteristics on tuber consumption, and differences in intake were assessed using statistical tests. Lastly, the dietary intakes of tuber consumers and non-consumers were compared after adjusting for energy and covariates to determine if there were any major differences in dietary intakes between the two groups. Results Fifty-five percent of the Brazilian population consumed tubers, which differed by macroregion. The intake of tubers among consumers also differed between macroregions. Overall, rural areas reported significantly higher mean daily intakes of tubers (122 g/day) among tuber consumers than urban areas (95 g/day). Mandioca and potato were the most commonly consumed tubers (59 and 43% prevalence, respectively, on any of the 2 days), while the highest daily intakes amongst tuber consumers across Brazil were noted for sweet potato (156 g/day) and potato (95 g/day). On a macroregion level, among tuber consumers, mandioca had the highest prevalence of consumption in the North (94%), Northeast (83%), and Central-West (68%), while consumption of potatoes was most prevalent in the Southeast (63%) and South (62%). Compared to women, small but significantly higher tuber intakes were noted for males (108 vs. 85 g/day). There were no significant differences in intakes among income quintiles. After adjusting for energy and other covariates, nutrient intakes between tuber and non-tuber consumers were not meaningfully different, with the exception of sodium (+ 6.0% comparing non-tuber to tuber consumers), iron (+ 6.1%), zinc (+ 5.7%), vitamin C (+ 8.3%), riboflavin (+ 9.0%), and folate (+ 7.9%). Conclusions Tuber consumption is influenced by regional and sociodemographic characteristics of the Brazilian population. When looking at energy-adjusted nutrient intakes, diets of tuber consumers have resulted in somewhat lower intakes of some micronutrients, namely riboflavin, folate, vitamin C, iron, sodium, and zinc.