Health & Nutrition Sciences Publications

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. 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.

Alexander, C., Brauchla, M., Sanoshy, K. D., Blonquist, T. M., . . . Swanson, K. S. (2022). Bowel habits, faecal microbiota and faecal bile acid composition of healthy adults consuming fruit pomace fibres: Two-arm, randomised, double-blinded, placebo-controlled trials. British Journal of Nutrition, 1-14. doi:10.1017/S0007114522002951

Abstract:

Dietary fibre modulates gastrointestinal (GI) health and function, providing laxation, shifting microbiota, and altering bile acid (BA) metabolism. Fruit juice production removes the polyphenol- and fibre-rich pomace fraction. The effects of orange and apple pomaces on GI outcomes were investigated in healthy, free-living adults. Healthy adults were enrolled in two double-blinded, crossover trials, being randomised by baseline bowel movement (BM) frequency. In the first trial, subjects (n 91) received orange juice (OJ, 0 g fibre/d) or OJ + orange pomace (OJ + P, 10 g fibre/d) for 4 weeks, separated by a 3-week washout. Similarly, in the second trial, subjects (n 90) received apple juice (AJ, 0 g fibre/d) or AJ + apple pomace (AJ + P, 10 g fibre/d). Bowel habit diaries, GI tolerance surveys and 3-d diet records were collected throughout. Fresh faecal samples were collected from a participant subset for microbiota and BA analyses in each study. Neither pomace interventions influenced BM frequency. At Week 4, OJ + P tended to increase (P = 0·066) GI symptom occurrence compared with OJ, while AJ + P tended (P = 0·089) to increase flatulence compared with AJ. Faecalibacterium (P = 0·038) and Negativibacillus (P = 0·043) were differentially abundant between pre- and post-interventions in the apple trial but were no longer significant after false discovery rate (FDR) correction. Baseline fibre intake was independently associated with several microbial genera in both trials. Orange or apple pomace supplementation was insufficient to elicit changes in bowel habits, microbiota diversity or BA of free-living adults with healthy baseline BM. Future studies should consider baseline BM frequency and habitual fibre intake.

Khomich, L. M., Berezhnaya, Y. A., Shashin, D. L., Polyakov, S. A., . . . Eller, K. I. (2022). Comparative analysis of the total content of polyphenols in some types of industrial juice products. Voprosy Pitaniia, 91(5), 124-132. doi:10.33029/0042-8833-2022-91-5-124-132 

Abstract:

Fruits are the most important source of polyphenols - substances that have a positive effect on human health. Modern technologies for the industrial processing of fruits into juice are aimed at preserving the useful components of the raw material in it. The issue of the content of polyphenols in industrial juice products and especially the change in their concentration over time is important for understanding the nutritional value of juice products and requires further study.

The purpose of the work is to study the total content of polyphenols depending on the type of juice products and the time elapsed since the product was manufactured.

Material and methods. The total content of polyphenols in terms of gallic acid was determined by the Folin-Ciocalteu method in 4 popular types of juice products (orange, grapefruit and apple juices, cherry nectar) of various brands and with different production dates. The results of the determination of polyphenols in 60 product samples taken from Russian retail chains were analyzed.

Results. Polyphenols are found in all types of products in significant quantities: in orange juices - from 678 to 870 mg/kg, in grapefruit juices - from 447 to 798 mg/kg, in apple juices - from 264 to 1320 mg/kg, in cherry nectars - from 696 to 1090 mg/kg. The highest average content was found in cherry nectars (859±106 mg/kg), followed by orange (781±54 mg/kg) and grapefruit juices (634±91 mg/kg). In apple juices, there is a significant variation in the content of polyphenols depending on the method of juice production - the highest content of polyphenols was found in straight-pressed apple juices (1119±124 mg/kg). The content of polyphenols in products stored for six months or more does not show any significant differences from the content in fresher products.

Conclusion. The study showed the presence of high concentrations of common polyphenols in juice products.

The dependence of the content of polyphenols in the product on the time elapsed since the production of the product was not found. Juice products of industrial production can make a significant contribution to the intake of polyphenols in the human body.

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, e21. 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, 35(6), 1230-1244. doi: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.

Liska, D. J, Dioum, E., Chu, Y., Mah, E. (2022). Narrative review on the effects of oat and sprouted oat components on blood pressure. Nutrients, 14(22), 4772. doi:10.3390/nu14224772

Abstract:

Hypertension (HTN) is a major risk factor for cardiovascular disease (CVD) and cognitive decline. Elevations in blood pressure (BP) leading to HTN can be found in young adults with increased prevalence as people age. Oats are known to decrease CVD risk via an established effect of β-glucan on the attenuation of blood cholesterol. Many past studies on CVD and oats have also reported a decrease in BP; however, a thorough assessment of oats and BP has not been conducted. Moreover, oats deliver several beneficial dietary components with putative beneficial effects on BP or endothelial function, such as β-glucan, γ-amino butyric acid (GABA), and phytochemicals such as avenanthramides. We conducted a comprehensive search for systematic reviews, meta-analyses, and clinical intervention studies on oats and BP and identified 18 randomized controlled trials (RCTs) and three meta-analyses that supported the role of oats in decreasing BP. Emerging data also suggest oat consumption may reduce the use of anti-hypertensive medications. The majority of these studies utilized whole oats or oat bran, which include a vast array of oat bioactives. Therefore, we also extensively reviewed the literature on these bioactives and their putative effect on BP-relevant mechanisms. The data suggest several oat components, such as GABA, as well as the delivery of high-quality plant protein and fermentable prebiotic fiber, may contribute to the anti-HTN effect of oats. In particular, GABA is enhanced in oat sprouts, which suggests this food may be particularly beneficial for healthy BP management.

Dioum, E. M., Schneider, K. L., Vigerust, D. J., Cox, B. D., . . . Furman, D. (2022). Oats lower age-related systemic chronic inflammation (iAge) in adults at risk for cardiovascular disease. Nutrients, 14(21), 4471. doi:10.3390/nu14214471

Abstract:

Despite being largely preventable, cardiovascular disease (CVD) is still the leading cause of death globally. Recent studies suggest that the immune system, particularly a form of systemic chronic inflammation (SCI), is involved in the mechanisms leading to CVD; thus, targeting SCI may help prevent or delay the onset of CVD. In a recent placebo-controlled randomized clinical trial, an oat product providing 3 g of β-Glucan improved cholesterol low-density lipoprotein (LDL) levels and lowered cardiovascular risk in adults with borderline high cholesterol. Here, we conducted a secondary measurement of the serum samples to test whether the oat product has the potential to reduce SCI and improve other clinical outcomes related to healthy aging. We investigated the effects of the oat product on a novel metric for SCI called Inflammatory Age^® (iAge^®), derived from the Stanford 1000 Immunomes Project. The iAge^® predicts multimorbidity, frailty, immune decline, premature cardiovascular aging, and all-cause mortality on a personalized level. A beneficial effect of the oat product was observed in subjects with elevated levels of iAge^® at baseline (>49.6 iAge^® years) as early as two weeks post-treatment. The rice control group did not show any significant change in iAge^®. Interestingly, the effects of the oat product on iAge^® were largely driven by a decrease in the Eotaxin-1 protein, an aging-related chemokine, independent of a person’s gender, body mass index, or chronological age. Thus, we describe a novel anti-SCI role for oats that could have a major impact on functional, preventative, and personalized medicine.

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: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.

Xu, D., Fu, L., Pan, D., Chu, Y., . . . Sun, G. (2022). Role of probiotics/synbiotic supplementation in glycemic control: A critical umbrella review of meta-analyses of randomized controlled trials. Critical Reviews in Food Science and Nutrition. doi:10.1080/10408398.2022.2117783

Abstract:

The evidence regarding the beneficial effects of probiotics/synbiotic supplementation have been revealed by several meta-analyses, however some of these studies have fielded inconsistent results and a conclusion has yet to be reached. Therefore, the aim of present umbrella meta-analyses was to assess relevant evidence and elucidate the efficacy of probiotics/synbiotic supplementation in glycemic control. A comprehensive search in four databases (Cochrane library, PubMed, Web of science and Scopus) was performed to collect relevant studies up to August 2022, the pooled effects were measured with the use of random/fix-effect model depends on the heterogeneity. A total of 47 eligible meta-analyses involving 47,720 participants were identified to evaluate the pooled effects. The overall results showed that probiotics/synbiotic supplementation delivered significant decreases in fast plasma glucose (ES = −0.408, 95% CI: −0.518, −0.298; P < 0.001; I² = 82.996, P < 0.001), fast plasma insulin (ES = −1.165, 95% CI: −1.454, −0.876; P < 0.001; I² = 89.629, P < 0.001), homeostasis model assessment of insulin resistance (ES = −0.539, 95% CI: −0.624, −0.454; P < 0.001; I² = 56.716, P < 0.001), and glycosylated hemoglobin (ES = −0.186, 95% CI: −0.270, −0.102; P < 0.001; I² = 59.647, P = 0.001). Subgroup analysis showed that patients with impaired glucose homeostasis might benefit the most from probiotics/synbiotic supplementation. In conclusion, current umbrella meta-analysis strongly supporting the beneficial health effects of probiotics/synbiotic supplementation in glycemic control.

Mah, E., Liska, D. J., Goltz, S., & Chu, Y. (2022). The effect of extracted and isolated fibers on appetite and energy intake: A comprehensive review of human intervention studies. Appetite, 180, 106340. doi:10.1016/j.appet.2022.106340

Abstract:

In light of the increasing prevalence of obesity and cardiometabolic diseases, the underconsumption of fiber is concerning due to its various associated health benefits such as weight management. Adding extracted or isolated dietary fibers into various consumer products is a practical strategy for addressing the fiber gap. This comprehensive review identified evidence on the efficacy of different types of extracted and isolated fibers in reducing appetite and energy intake. Published reports of randomized controlled trials assessing appetite or energy intake in healthy adults were systematically searched, and those investigating extracted and isolated fibers following acute or chronic intake were selected. A total of 136 studies, consisting of 107 acute studies and 29 chronic studies, were included in the review. Overall, most fiber types did not show significant effects on appetite ratings and energy intakes. Acute intakes of two viscous fibers, alginate or guar gum, as well as oat fiber, were observed to most frequently result in reductions in appetite ratings. Additionally, chronic, but not acute, intakes of resistant maltodextrin/dextrin were also beneficial for appetite ratings. Viscous fibers were more likely to improve appetite ratings compared to non-viscous fibers, and fermentability did not appear to affect appetite ratings. Unfortunately, the current evidence base is highly varied due to the many differences in methodology and limited research on many of the fibers. While the possible benefits of extracted and isolated fibers on appetite sensations, food intake, and ultimately body weight regulation should not be completely dismissed, our review highlights the complexity of this research area and the gaps that need to be addressed to improve the robustness of the evidence.

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.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.

Zhouyao, H., Malunga, L. N., Chu, Y., Eck, P., . . . Thandapilly, S. J. (2022). The inhibition of intestinal glucose absorption by oat-derived avenanthramides. Journal of Food Biochemistry, 46(10), e14324. doi:10.1111/jfbc.14324

Abstract:

Avenanthramides are phenolic compounds unique to oats and may contribute to health-promoting properties associated with oat consumption. This study used Xenopus laevis oocytes expressing the glucose transporters, glucose transporter 2 (GLUT2) or sodium–glucose transport protein 1 (SGLT1) and human Caco-2 cells models to investigate the effect of oat avenanthramides on human intestinal glucose transporters. The presence of avenanthramide reduced the glucose uptake in a dose-dependent manner in Caco-2 cells. Glucose uptake in oocytes expressing either GLUT2 or SGLT1 was nullified by oat avenanthramide. There was no significant difference between the inhibition potencies of avenanthramides C and B. Thus, our results suggest that avenanthramides may contribute to the antidiabetic properties of oats.

Smirnova, D. V., Rehm, C. D., Fritz, R. D., Kutepova, I. S., . . . Berezhnaya, Y. A. (2022). Vitamin D status of the Russian adult population from 2013 to 2018. Scientific Reports, 12, 16604. doi:10.1038/s41598-022-21221-4

Abstract:

Vitamin D deficiency is widespread globally, however available data for the Russian adult population is fragmented. This cross-sectional study used secondary data for individuals undergoing testing for vitamin D concentrations from 2013 to 2018 by InVitro laboratory. 25(OH)D serum concentration was determined using chemiluminescent microparticle immunoassay. The mean, median, and proportion with severe, deficient, insufficient and sufficient 25-hydroxyvitamin D (25(OH)D) concentrations were estimated. Splines examined the effect of latitude on 25(OH)D concentrations. Data were available for 30,040 subjects age ≥ 18 years. 24.2% of the sampled population had sufficient (30–< 150 25(OH)D ng/mL), 34% deficient (10–19.9 ng/mL) and 5.6% severely deficient (< 10 ng/mL) status. Average 25(OH)D concentrations were highest among 30–44 years and lowest amongst older adults; females had modestly higher values. Concentrations were 15% higher in fall/summer vs. winter/spring. A non-linear relationship was observed by latitude; the highest 25(OH)D concentrations were observed near 54°N, decreasing at more southern latitudes for women and more northern latitudes for both sexes. These results are comparable to other Northern European publications and limited Russian samples demonstrating low concentrations. Acknowledging that nationally-representative and randomly sampled data are needed, the present data suggest the burden may be high and identifies some population sub-groups and geographic areas with a higher potential deficiency of vitamin D.

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, 151(6), 1436. 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, 5, 267–279. 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, 151(9), 2655–2666. 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.