Nutrients

14 pages, 484 KiB

Open AccessFeature PaperArticle

Musculoskeletal Health in Active Ambulatory Men with Cerebral Palsy and the Impact of Vitamin D

by Christina Kate Langley, Gladys Leopoldine Onambélé-Pearson, David Thomas Sims, Ayser Hussain, Aidan John Buffey, Holly Leigh Bardwell and Christopher Ian Morse

Nutrients 2021, 13(7), 2481; https://doi.org/10.3390/nu13072481 - 20 Jul 2021

Cited by 4 | Viewed by 3608

Abstract

Purpose: (1) To determine the contribution of diet, time spent outdoors, and habitual physical activity (PA) on vitamin D status in men with cerebral palsy (CP) compared to physical activity matched controls (TDC) without neurological impairment; (2) to determine the role of vitamin [...] Read more.

Purpose: (1) To determine the contribution of diet, time spent outdoors, and habitual physical activity (PA) on vitamin D status in men with cerebral palsy (CP) compared to physical activity matched controls (TDC) without neurological impairment; (2) to determine the role of vitamin D on musculoskeletal health, morphology, and function in men with CP compared to TDC. Materials and methods: A cross-sectional comparison study where 24 active, ambulant men with CP aged 21.0 ± 1.4 years (Gross Motor Function Classification Score (I–II) and 24 healthy TDC aged 25.3 ± 3.1 years completed in vivo assessment of musculoskeletal health, including: vastus lateralis anatomical cross-sectional area (VL ACSA), isometric knee extension maximal voluntary contraction (KE iMVC), 10 m sprint, vertical jumps (VJ), and radius and tibia bone ultrasound (US) T_us and Z_us scores. Assessments of vitamin D status through venous samples of serum 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone, dietary vitamin D intake from food diary, and total sun exposure via questionnaire were also taken. Results: Men with CP had 40.5% weaker KE iMVC, 23.7% smaller VL ACSA, 22.2% lower VJ, 14.6% lower KE iMVC/VL ACSA ratio, 22.4% lower KE iMVC/body mass (BM) ratio, and 25.1% lower KE iMVC/lean body mass (LBM) ratio (all p < 0.05). Radius T_us and Z_us scores were 1.75 and 1.57 standard deviations lower than TDC, respectively (p < 0.05), whereas neither tibia T_us nor Z_us scores showed any difference compared to TDC (p > 0.05). The 25(OH)D was not different between groups, and 90.9% of men with CP and 91.7% of TDC had low 25(OH)D levels when compared to current UK recommendations. The 25(OH)D was positively associated with KE iMVC/LBM ratio in men with CP (r = 0.500, p = 0.020) but not in TDC (r = 0.281, p = 0.104). Conclusion: Musculoskeletal outcomes in men with CP were lower than TDC, and despite there being no difference in levels of 25(OH)D between the groups, 25 (OH)D was associated with strength (KE iMVC/LBM) in the CP group but not TDC. The findings suggest that vitamin D deficiency can accentuate some of the condition-specific impairments to musculoskeletal outcomes. Full article

(This article belongs to the Special Issue Benefits of Vitamin D in Health and Diseases)

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11 pages, 261 KiB

Open AccessArticle

Associations between Maternal Iron Supplementation in Pregnancy and Changes in Offspring Size at Birth Reflect Those of Multiple Micronutrient Supplementation

by Clive J. Petry, Ken K. Ong, Ieuan A. Hughes and David B. Dunger

Nutrients 2021, 13(7), 2480; https://doi.org/10.3390/nu13072480 - 20 Jul 2021

Cited by 10 | Viewed by 3310

Abstract

It was previously observed that in a population of a high-income country, dietary multiple micronutrient supplementation in pregnancy was associated with an increased risk of gestational diabetes (GDM) and increased offspring size at birth. In this follow-up study, we investigated whether similar changes [...] Read more.

It was previously observed that in a population of a high-income country, dietary multiple micronutrient supplementation in pregnancy was associated with an increased risk of gestational diabetes (GDM) and increased offspring size at birth. In this follow-up study, we investigated whether similar changes are observed with dietary iron supplementation. For this we used the prospective Cambridge Baby Growth Study with records of maternal GDM status, nutrient supplementation, and extensive offspring birth size measurements. Maternal iron supplementation in pregnancy was associated with GDM development (risk ratio 1.67 (1.01–2.77), p = 0.048, n = 677) as well as offspring size and adiposity (n = 844–868) at birth in terms of weight (β’ = 0.078 (0.024–0.133); p = 0.005), head circumference (β’ = 0.060 (0.012–0.107); p = 0.02), body mass index (β’ = 0.067 (0.014–0.119); p = 0.01), and various skinfold thicknesses (β’ = 0.067–0.094; p = 0.03–0.003). In a subset of participants for whom GDM statuses were available, all these associations were attenuated by adjusting for GDM. Iron supplementation also attenuated the associations between multiple micronutrient supplementation and these same measures. These results suggest that iron supplementation may mediate the effects associated with multiple micronutrient supplementation in pregnancy in a high-income country, possibly through the increased risk of developing GDM. Full article

(This article belongs to the Special Issue Gestational Diabetes: Nutritional Aspects of Cause, Consequences, and Treatment)

17 pages, 8622 KiB

Open AccessReview

Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis

by Nora Suleiman-Martos, Rubén A. García-Lara, María Begoña Martos-Cabrera, Luis Albendín-García, José Luis Romero-Béjar, Guillermo A. Cañadas-De la Fuente and José L. Gómez-Urquiza

Nutrients 2021, 13(7), 2478; https://doi.org/10.3390/nu13072478 - 20 Jul 2021

Cited by 40 | Viewed by 9841

Abstract

Currently, one of the main public health problems among children and adolescents is poor adherence to healthy habits, leading to increasingly high rates of obesity and the comorbidities that accompany obesity. Early interventions are necessary, and among them, the use of gamification can [...] Read more.

Currently, one of the main public health problems among children and adolescents is poor adherence to healthy habits, leading to increasingly high rates of obesity and the comorbidities that accompany obesity. Early interventions are necessary, and among them, the use of gamification can be an effective method. The objective was to analyse the effect of game-based interventions (gamification) for improving nutritional habits, knowledge, and changes in body composition. A systematic review and meta-analysis were performed in CINAHL, EMBASE, LILACS, MEDLINE, SciELO, and Scopus databases, following the PRISMA recommendations. There was no restriction by year of publication or language. Only randomized controlled trials were included. Twenty-three articles were found. After the intervention, the consumption of fruit and vegetables increased, as well as the knowledge on healthy food groups. The means difference showed a higher nutritional knowledge score in the intervention group 95% CI 0.88 (0.05–1.75). No significant effect of gamification was found for body mass index z-score. Gamification could be an effective method to improve nutritional knowledge about healthier nutritional habits. Promoting the development of effective educational tools to support learning related to nutrition is necessary in order to avoid and prevent chronic diseases. Full article

(This article belongs to the Section Nutritional Policies and Education for Health Promotion)

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11 pages, 309 KiB

Open AccessReview

Complementary Feeding: Recommendations for the Introduction of Allergenic Foods and Gluten in the Preterm Infant

by Federica Chiale, Elena Maggiora, Arianna Aceti, Nadia Liotto, Alessandra Coscia, Chiara Peila, Maria Elisabetta Baldassarre, Enrico Bertino and Francesco Cresi

Nutrients 2021, 13(7), 2477; https://doi.org/10.3390/nu13072477 - 20 Jul 2021

Cited by 4 | Viewed by 4263

Abstract

Background: The aim of this systematic review is to analyze the available literature on the introduction of allergenic foods and gluten among preterm infants. Methods: A systematic review of published studies concerning the introduction of gluten and allergenic foods in preterm infants was [...] Read more.

Background: The aim of this systematic review is to analyze the available literature on the introduction of allergenic foods and gluten among preterm infants. Methods: A systematic review of published studies concerning the introduction of gluten and allergenic foods in preterm infants was performed on PubMed and on the Cochrane Library. Results: Of the 174 PubMed results, 15 papers were considered suitable for the review. A total of 83 records were identified through the Cochrane Library search; eight papers were included in the review. Additional papers were identified from the reference lists of included studies. A secondary search was conducted on the same databases to find recommendations and advice regarding healthy full-term infants that could be translated to preterm infants. Therefore, 59 additional papers were included in the review. Conclusions: Current guidelines for the introduction of solid food cannot be directly transposed to preterm infants. Further research is needed to provide evidence-based guidelines regarding weaning in preterm infants. To date, we can suggest that in preterm infants allergenic foods and gluten may be introduced when complementary feeding is started, any time after 4 months of corrected age, avoiding delayed introduction and irrespective of infants’ relative risk of developing allergy. Avoiding large amounts of gluten during the first few weeks after gluten introduction and during infancy is advised, despite limited evidence to support this recommendation. Full article

(This article belongs to the Special Issue Complementary Feeding in Preterm Newborns)

20 pages, 1219 KiB

Open AccessReview

Effects of Bergamot Polyphenols on Mitochondrial Dysfunction and Sarcoplasmic Reticulum Stress in Diabetic Cardiomyopathy

by Jessica Maiuolo, Cristina Carresi, Micaela Gliozzi, Vincenzo Musolino, Federica Scarano, Anna Rita Coppoletta, Lorenza Guarnieri, Saverio Nucera, Miriam Scicchitano, Francesca Bosco, Stefano Ruga, Maria Caterina Zito, Roberta Macri, Antonio Cardamone, Maria Serra, Rocco Mollace, Annamaria Tavernese and Vincenzo Mollace

Nutrients 2021, 13(7), 2476; https://doi.org/10.3390/nu13072476 - 20 Jul 2021

Cited by 23 | Viewed by 5077

Abstract

Cardiovascular disease is the leading cause of death and disability in the Western world. In order to safeguard the structure and the functionality of the myocardium, it is extremely important to adequately support the cardiomyocytes. Two cellular organelles of cardiomyocytes are essential for [...] Read more.

Cardiovascular disease is the leading cause of death and disability in the Western world. In order to safeguard the structure and the functionality of the myocardium, it is extremely important to adequately support the cardiomyocytes. Two cellular organelles of cardiomyocytes are essential for cell survival and to ensure proper functioning of the myocardium: mitochondria and the sarcoplasmic reticulum. Mitochondria are responsible for the energy metabolism of the myocardium, and regulate the processes that can lead to cell death. The sarcoplasmic reticulum preserves the physiological concentration of the calcium ion, and triggers processes to protect the structural and functional integrity of the proteins. The alterations of these organelles can damage myocardial functioning. A proper nutritional balance regarding the intake of macronutrients and micronutrients leads to a significant improvement in the symptoms and consequences of heart disease. In particular, the Mediterranean diet, characterized by a high consumption of plant-based foods, small quantities of red meat, and high quantities of olive oil, reduces and improves the pathological condition of patients with heart failure. In addition, nutritional support and nutraceutical supplementation in patients who develop heart failure can contribute to the protection of the failing myocardium. Since polyphenols have numerous beneficial properties, including anti-inflammatory and antioxidant properties, this review gathers what is known about the beneficial effects of polyphenol-rich bergamot fruit on the cardiovascular system. In particular, the role of bergamot polyphenols in mitochondrial and sarcoplasmic dysfunctions in diabetic cardiomyopathy is reported. Full article

(This article belongs to the Special Issue Nutraceutical Supplements in Heart Failure)

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10 pages, 431 KiB

Open AccessArticle

Dieting and Disinhibited Eating Patterns in Adult Women with Normal Body Weight: Does Rumination Matter?

by Justyna Waliłko, Paulina Bronowicka, Jinbo He and Anna Brytek-Matera

Nutrients 2021, 13(7), 2475; https://doi.org/10.3390/nu13072475 - 20 Jul 2021

Cited by 4 | Viewed by 4491

Abstract

Dieting and disinhibited eating patterns are presented in both clinical and nonclinical samples. Repetitive negative thinking (i.e., rumination) may lead to maladaptive eating behaviors. While numerous studies have focused on dieting and disinhibited eating behaviors in clinical samples, less is known about these [...] Read more.

Dieting and disinhibited eating patterns are presented in both clinical and nonclinical samples. Repetitive negative thinking (i.e., rumination) may lead to maladaptive eating behaviors. While numerous studies have focused on dieting and disinhibited eating behaviors in clinical samples, less is known about these behaviors in nonclinical samples with normal body weight. Therefore, the present study aimed to explore how dieting, uncontrolled eating and emotional eating are related to rumination in adult women with normal body weight. One hundred eighty-eight women (M_age = 29.46 ± 8.94; M_BMI = 23.16 ± 4.04) were involved in the current study. The Eating Attitudes Test, the Three-Factor Eating Questionnaire-R18 and the Perseverative Thinking Questionnaire were administered to the participants. The results showed that repetitive negative thinking was a partial mediator in the relationship between dieting and uncontrolled eating, as well as in the relationship between dieting and emotional eating. Targeting repetitive negative thinking may be important for reducing disinhibited eating patterns in women with normal body weight. Full article

(This article belongs to the Special Issue Nutrient Intake and Physical Exercise as Modulators of Healthy Women)

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18 pages, 1368 KiB

Open AccessFeature PaperReview

Mechanisms of Glucose Absorption in the Small Intestine in Health and Metabolic Diseases and Their Role in Appetite Regulation

by Lyudmila V. Gromova, Serguei O. Fetissov and Andrey A. Gruzdkov

Nutrients 2021, 13(7), 2474; https://doi.org/10.3390/nu13072474 - 20 Jul 2021

Cited by 66 | Viewed by 14599

Abstract

The worldwide prevalence of metabolic diseases such as obesity, metabolic syndrome and type 2 diabetes shows an upward trend in recent decades. A characteristic feature of these diseases is hyperglycemia which can be associated with hyperphagia. Absorption of glucose in the small intestine [...] Read more.

The worldwide prevalence of metabolic diseases such as obesity, metabolic syndrome and type 2 diabetes shows an upward trend in recent decades. A characteristic feature of these diseases is hyperglycemia which can be associated with hyperphagia. Absorption of glucose in the small intestine physiologically contributes to the regulation of blood glucose levels, and hence, appears as a putative target for treatment of hyperglycemia. In fact, recent progress in understanding the molecular and cellular mechanisms of glucose absorption in the gut and its reabsorption in the kidney helped to develop a new strategy of diabetes treatment. Changes in blood glucose levels are also involved in regulation of appetite, suggesting that glucose absorption may be relevant to hyperphagia in metabolic diseases. In this review we discuss the mechanisms of glucose absorption in the small intestine in physiological conditions and their alterations in metabolic diseases as well as their relevance to the regulation of appetite. The key role of SGLT1 transporter in intestinal glucose absorption in both physiological conditions and in diabetes was clearly established. We conclude that although inhibition of small intestinal glucose absorption represents a valuable target for the treatment of hyperglycemia, it is not always suitable for the treatment of hyperphagia. In fact, independent regulation of glucose absorption and appetite requires a more complex approach for the treatment of metabolic diseases. Full article

(This article belongs to the Special Issue Macronutrients and Human Health)

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18 pages, 342 KiB

Open AccessReview

Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss

by David McCarthy and Aloys Berg

Nutrients 2021, 13(7), 2473; https://doi.org/10.3390/nu13072473 - 20 Jul 2021

Cited by 45 | Viewed by 19907

Abstract

With energy intake restriction and exercise remaining the key diet and lifestyle approaches to weight loss, this is not without potential negative implications for body composition, metabolic health, and quality and quantity of life. Ideally, weight loss should be derived almost exclusively from [...] Read more.

With energy intake restriction and exercise remaining the key diet and lifestyle approaches to weight loss, this is not without potential negative implications for body composition, metabolic health, and quality and quantity of life. Ideally, weight loss should be derived almost exclusively from the fat mass compartment as this is the main driver of metabolic disease, however, several studies have shown that there is an accompanying loss of tissue from the fat-free compartment, especially skeletal muscle. Population groups including post-menopausal women, the elderly, those with metabolic disease and athletes may be particularly at risk of skeletal muscle loss when following a weight management programme. Research studies that have addressed this issue across a range of population groups are reviewed with a focus upon the contribution of resistance and endurance forms of exercise and a higher intake dietary protein above the current guideline of 0.8 g/kg body weight/day. While findings can be contradictory, overall, the consensus appears that fat-free and skeletal muscle masses can be preserved, albeit to varying degrees by including both forms of exercise (but especially resistance forms) in the weight management intervention. Equally, higher intakes of protein can protect loss of these body compartments, acting either separately or synergistically with exercise. Elderly individuals in particular may benefit most from this approach. Thus, the evidence supports the recommendations for intakes of protein above the current guidelines of 0.8 g/kg body weight/d for the healthy elderly population to also be incorporated into the dietary prescription for weight management in this age group. Full article

(This article belongs to the Special Issue Nutrients Supporting an Active Lifestyle)

10 pages, 253 KiB

Open AccessArticle

Dietary Modelling to Explore the Impact of Potassium Chloride Replacement for Sodium in Bread for Adults with Chronic Kidney Disease

by Rebecca Morrison, Jordan Stanford and Kelly Lambert

Nutrients 2021, 13(7), 2472; https://doi.org/10.3390/nu13072472 - 20 Jul 2021

Cited by 4 | Viewed by 3124

Abstract

Food manufacturers are increasingly substituting potassium chloride (KCl) in food products so as to reduce the sodium chloride content. Bread and bread products are common staple foods in many Western households and are a target for recipe reformulation using KCl. Given that chronic [...] Read more.

Food manufacturers are increasingly substituting potassium chloride (KCl) in food products so as to reduce the sodium chloride content. Bread and bread products are common staple foods in many Western households and are a target for recipe reformulation using KCl. Given that chronic kidney disease (CKD) is a medical condition of global importance that requires dietary potassium restriction in the later stages, we sought to evaluate the impact and safety of varying levels of KCl substitution in bread products. We undertook a secondary analysis of dietary data from the National Nutrition and Physical Activity Survey 2011–2012 for 12,152 participants (154 participants with CKD). The sodium chloride content in bread and bread-based products was substituted with 20%, 30%, and 40% of KCl. The contribution of these alterations in the dietary potassium intake to the total daily potassium intake were then examined. The replacement of sodium in bread with varying amounts of KCl (20%, 30%, and 40%) resulted in one third of people with CKD exceeding the safe limits for dietary potassium consumption (31.8%, 32.6%, and 33%, respectively). KCl substitution in staple foods such as bread and bread products have serious and potentially fatal consequences for people who need to restrict dietary potassium. Improved food labelling is required for consumers to avoid excessive consumption. Full article

(This article belongs to the Special Issue The Role of Dietary Potassium in Human Health)

18 pages, 1327 KiB

Open AccessArticle

Use of Different Food Classification Systems to Assess the Association between Ultra-Processed Food Consumption and Cardiometabolic Health in an Elderly Population with Metabolic Syndrome (PREDIMED-Plus Cohort)

by Celia Martinez-Perez, Rodrigo San-Cristobal, Pilar Guallar-Castillon, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Dolores Corella, Olga Castañer, Jose Alfredo Martinez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Lapetra, Lluis Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, José J. Gaforio, Pilar Matía-Martín, Josep Vidal, Clotilde Vázquez, Emilio Ros, Maira Bes-Rastrollo, Nancy Babio, Jose V. Sorlí, Camille Lassale, Beatriz Pérez-Sanz, Jessica Vaquero-Luna, María Julia Ajejas Bazán, María Concepción Barceló-Iglesias, Jadwiga Konieczna, Antonio García Ríos, María Rosa Bernal-López, José Manuel Santos-Lozano, Estefanía Toledo, Nerea Becerra-Tomás, Olga Portoles, María Dolores Zomeño, Itziar Abete, Anai Moreno-Rodriguez, Oscar Lecea-Juarez, Stephanie K. Nishi, Júlia Muñoz-Martínez, José M. Ordovás and Lidia Daimiel Show full author list Hide full author list

Nutrients 2021, 13(7), 2471; https://doi.org/10.3390/nu13072471 - 20 Jul 2021

Cited by 54 | Viewed by 10228

Abstract

The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification [...] Read more.

The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers. Full article

(This article belongs to the Special Issue Consumption of Ultra-Processed Foods and Health Harm)

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12 pages, 3043 KiB

Open AccessArticle

Both Isocarbohydrate and Hypercarbohydrate Fruit Preloads Curbed Postprandial Glycemic Excursion in Healthy Subjects

by Xuejiao Lu, Jiacan Lu, Zhihong Fan, Anshu Liu, Wenqi Zhao, Yixue Wu and Ruixin Zhu

Nutrients 2021, 13(7), 2470; https://doi.org/10.3390/nu13072470 - 19 Jul 2021

Cited by 10 | Viewed by 3592

Abstract

This study aimed to investigate the impact of fruit preloads on the acute postprandial glycemic response (PGR) and satiety response of a rice meal in healthy female subjects based on iso-carbohydrate (IC) and hyper-carbohydrate (HC) contents, respectively. The IC test meals including (1) [...] Read more.

This study aimed to investigate the impact of fruit preloads on the acute postprandial glycemic response (PGR) and satiety response of a rice meal in healthy female subjects based on iso-carbohydrate (IC) and hyper-carbohydrate (HC) contents, respectively. The IC test meals including (1) rice preload (R + 35R), (2) orange preload (O + 35R), (3) apple preload (A + 35R) and (4) pear preload (P + 35R), contained 50.0 g available carbohydrates (AC) where the preload contributed 15.0 g and rice provided 35.0 g. The HC meals included (1) orange preload (O + 50R), (2) apple preload (A+50R) and (3) pear preload (P + 50R), each containing 65.0 g AC, where the fruits contributed 15.0 g and rice provided 50.0 g. Drinking water 30 min before the rice meal was taken as reference (W + 50R). All the preload treatments, irrespective of IC or HC meals, resulted in remarkable reduction (p < 0.001) in terms of incremental peak glucose (IPG) and the maximum amplitude of glycemic excursion in 180 min (MAGE_0–180), also a significant decrease (p < 0.05) in the area of PGR contributed by per gram of AC (AAC), compared with the W + 50R. Apple elicited the lowest PGR among all test meals, as the A + 35R halved the IPG and slashed the incremental area under the curve in 180 min (iAUC_0–180) by 45.7%, while the A + 50R reduced the IPG by 29.7%, compared with the W + 50R. All the preload meals and the reference meal showed comparable self-reported satiety in spite of the difference in AC. In conclusion, pre-meal consumption of three fruits effectively curbed post-meal glycemia even in the case of a 30% extra carbohydrate load. Full article

(This article belongs to the Section Carbohydrates)

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14 pages, 1434 KiB

Open AccessArticle

Psychological and Gastrointestinal Symptoms of Patients with Irritable Bowel Syndrome Undergoing a Low-FODMAP Diet: The Role of the Intestinal Barrier

by Laura Prospero, Giuseppe Riezzo, Michele Linsalata, Antonella Orlando, Benedetta D’Attoma and Francesco Russo

Nutrients 2021, 13(7), 2469; https://doi.org/10.3390/nu13072469 - 19 Jul 2021

Cited by 21 | Viewed by 4781

Abstract

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (LFD) improves both gastrointestinal (GI) symptoms and the psychological profile of patients with irritable bowel syndrome with diarrhea (IBS-D). The effects of 12 weeks of LFD on GI symptom and psychological profiles in [...] Read more.

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (LFD) improves both gastrointestinal (GI) symptoms and the psychological profile of patients with irritable bowel syndrome with diarrhea (IBS-D). The effects of 12 weeks of LFD on GI symptom and psychological profiles in relation to inflammation and the involvement of the intestinal barrier were studied in twenty IBS-D patients. The IBS Severity Scoring System, the Symptom Checklist-90-Revised, the Italian version of the 36-Item Short-Form Health Survey, the IBS-Quality of Life (QoL) questionnaire, and the Psychophysiological questionnaire were administered. The GI barrier function was assessed by sugar absorption test, the serum and fecal zonulin levels, and the serum levels of intestinal fatty-acid binding protein and diamine oxidase. Interleukins (ILs) and lipopolysaccharide (LPS) serum levels were evaluated along with dysbiosis. At the end of LFD, GI symptoms, psychological state (mainly anxiety, somatization, psychoticism, and interpersonal sensitivity), and QoL significantly improved in these patients. Simultaneously, an improvement in small intestinal permeability and intestinal mucosal integrity occurred, while IL-6, Il-10, LPS, and fermentative dysbiosis significantly decreased. The LFD can modify the immune-inflammatory features and enhance intestinal permeability and mucosal integrity, thus determining a concurrent improvement in the clinical and psychological conditions. Full article

(This article belongs to the Section Clinical Nutrition)

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17 pages, 308 KiB

Open AccessArticle

Efficacy of a Multi-Component m-Health Diet, Physical Activity, and Sleep Intervention on Dietary Intake in Adults with Overweight and Obesity: A Randomised Controlled Trial

by Sasha Fenton, Tracy L. Burrows, Clare E. Collins, Anna T. Rayward, Beatrice Murawski and Mitch J. Duncan

Nutrients 2021, 13(7), 2468; https://doi.org/10.3390/nu13072468 - 19 Jul 2021

Cited by 6 | Viewed by 4821

Abstract

This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and [...] Read more.

This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and sleep intervention was more effective at improving dietary intake than the traditional diet and PA intervention. A total of 116 adults (70% female, 44.5 years, BMI 31.7 kg/m²) were randomised to either traditional diet and PA intervention; enhanced diet, PA, and sleep intervention; or wait-list control. To examine between-group differences, intervention groups were pooled and compared with the control. Then, the two intervention groups were compared. At six months, the pooled intervention group consumed 1011 fewer kilojoules/day (95% CI −1922, −101), less sodium (−313.2 mg/day; 95% CI −591.3, −35.0), and higher %EI from fruit (+2.1%EI; 95% CI 0.1, 4.1) than the controls. There were no differences in intake between the enhanced and traditional groups at six months. At 12 months, the pooled intervention and control groups reported no significant differences. However, compared to the traditional group, the enhanced reported higher %EI from nutrient-dense foods (+7.4%EI; 95% CI 1.3, 13.5) and protein (+2.4%EI; 95% CI 0.1, 4.6), and reduced %EI from fried/takeaway foods (−3.6%EI; 95% CI −6.5, −0.7), baked sweet products (−2.0%EI; 95% CI −3.6, −0.4), and packaged snacks (−1.1%EI; 95% CI −2.2, −0.3). This weight loss intervention reduced total energy and sodium intakes as well as increased fruit intake in adults at six months. The enhanced intervention group reported improved dietary intake relative to the traditional group at 12 months. Full article

(This article belongs to the Special Issue Nutrition at the Interface of Sleep and Circadian Rhythms: Implications for Health)

16 pages, 7222 KiB

Open AccessArticle

Gastrointestinal Digestion of a Grape Pomace Extract: Impact on Intestinal Barrier Permeability and Interaction with Gut Microbiome

by Diego Taladrid, Dolores González de Llano, Irene Zorraquín-Peña, Alba Tamargo, Mariana Silva, Natalia Molinero, M. Victoria Moreno-Arribas and Begoña Bartolomé

Nutrients 2021, 13(7), 2467; https://doi.org/10.3390/nu13072467 - 19 Jul 2021

Cited by 19 | Viewed by 4192

Abstract

Grape pomace (GP) is a winemaking by-product rich in polyphenols and fibre. Supplementation with GP extracts has shown potential benefits against oxidative stress- and inflammation-related pathologies. As a new nutritional target, this paper explores the impact of the ingestion of a grape pomace [...] Read more.

Grape pomace (GP) is a winemaking by-product rich in polyphenols and fibre. Supplementation with GP extracts has shown potential benefits against oxidative stress- and inflammation-related pathologies. As a new nutritional target, this paper explores the impact of the ingestion of a grape pomace extract on intestinal barrier functionality. A GP extract was sequentially subjected to gastrointestinal and colonic digestion using the dynamic gastrointestinal simulator (simgi^®). This generated two simulated fluids: intestinal-digested extract (IDE) and colonic-digested extract (CDE). The effects of these two fluids on paracellular permeability and the expression of tight junction (TJ) proteins (i.e., zonula occludens-1 (ZO-1) and occludin) were assessed in Caco-2-cell monolayers grown in Transwell^® inserts. The IDE fluid significantly (p < 0.001) reduced the paracellular transport of FITC-dextran with respect to the control, whereas no significant differences (p > 0.05) were found for CDE, which could be due, at least partially, to the pro-leaky effect of the colonic digestion medium. Accordant slight increases in the mRNA levels of both ZO-1 and occludin were observed for IDE, but without statistical significance. Additionally, the colonic fermentation of the GP extract promoted the production of short-chain fatty acids (SCFA) and phenolic metabolites and led to changes in the relative abundance of some bacteria that might affect paracellular permeability. Overall, this paper reports first trends about the effects of grape pomace extracts on intestinal permeability that would require further confirmation in future experiments. Full article

(This article belongs to the Special Issue The Nutritional Potential of Agri-Food By-Products in Human Health)

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11 pages, 5566 KiB

Open AccessArticle

Synergistic Interaction in the Analgesic-Like Effects of Maqui Berry and Citrus Is Antagonized by Sweeteners

by Vicente Agulló, María Eva González-Trujano, Alberto Hernandez-Leon, Erika Estrada-Camarena, Francisco Pellicer and Cristina García-Viguera

Nutrients 2021, 13(7), 2466; https://doi.org/10.3390/nu13072466 - 19 Jul 2021

Cited by 3 | Viewed by 3142

Abstract

Although physiologically pain has a protective function, in many diseases, it is one of the most prominent symptoms. Today, new trends are focused on finding more natural alternatives to conventional treatments to alleviate it. Thereby, the purpose of this investigation was to obtain [...] Read more.

Although physiologically pain has a protective function, in many diseases, it is one of the most prominent symptoms. Today, new trends are focused on finding more natural alternatives to conventional treatments to alleviate it. Thereby, the purpose of this investigation was to obtain preclinical data of the antinociceptive properties of a lyophilized obtained from a newly designed maqui–citrus beverage alone and added with different sweeteners. To achieve this objective, maqui berry and citrus pharmacological activity were studied separately, as well as the interaction of both ingredients. In addition, due to the controversy generated regarding the intake of sugars, related to different metabolic diseases, the influence of different sweeteners (stevia, sucralose, or sucrose) was studied to determine their possible influence on the bioactive compounds of this product. For the attainment of our goals, a pharmacological evaluation, using the 1% formalin test, a nociceptive pain model in mice, was performed by using a sub-efficacious dosage of Maqui (25 mg/kg, i.p.) alone and combined with citrus, and then compared with the effects obtained in the presence of the different sweeteners. As a result, the antinociceptive response of the maqui was synergized in the presence of citrus in the neurogenic and inflammatory phases of the formalin test. However, this response was partially or totally reduced in the presence of the sweeteners. Our study gives preclinical evidence that a combination of maqui and citrus might exert beneficial actions to relieve pain, whereas the presence of sweeteners could reduce or avoid it. Full article

(This article belongs to the Special Issue Food and Nutrition Research – the Omics Era)

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21 pages, 1345 KiB

Open AccessArticle

Effects of DHA-Rich n-3 Fatty Acid Supplementation and/or Resistance Training on Body Composition and Cardiometabolic Biomarkers in Overweight and Obese Post-Menopausal Women

by Elisa Félix-Soriano, Alejandro Martínez-Gayo, María José Cobo, Adriana Pérez-Chávez, Javier Ibáñez-Santos, Natalia Palacios Samper, Iñaki Goikoetxea Galarza, Marta Cuervo, Marisol García-Unciti, Pedro González-Muniesa, Silvia Lorente-Cebrián and María J. Moreno-Aliaga

Nutrients 2021, 13(7), 2465; https://doi.org/10.3390/nu13072465 - 19 Jul 2021

Cited by 24 | Viewed by 24132

Abstract

Resistance training (RT) and n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation have emerged as strategies to improve muscle function in older adults. Overweight/obese postmenopausal women (55–70 years) were randomly allocated to one of four experimental groups, receiving placebo (olive oil) or docosahexaenoic acid [...] Read more.

Resistance training (RT) and n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation have emerged as strategies to improve muscle function in older adults. Overweight/obese postmenopausal women (55–70 years) were randomly allocated to one of four experimental groups, receiving placebo (olive oil) or docosahexaenoic acid (DHA)-rich n-3 PUFA supplementation alone or in combination with a supervised RT-program for 16 weeks. At baseline and at end of the trial, body composition, anthropometrical measures, blood pressure and serum glucose and lipid biomarkers were analyzed. Oral glucose tolerance tests (OGTT) and strength tests were also performed. All groups exhibit a similar moderate reduction in body weight and fat mass, but the RT-groups maintained bone mineral content, increased upper limbs lean mass, decreased lower limbs fat mass, and increased muscle strength and quality compared to untrained-groups. The RT-program also improved glucose tolerance (lowering the OGTT incremental area under the curve). The DHA-rich supplementation lowered diastolic blood pressure and circulating triglycerides and increased muscle quality in lower limbs. In conclusion, 16-week RT-program improved segmented body composition, bone mineral content, and glucose tolerance, while the DHA-rich supplement had beneficial effects on cardiovascular health markers in overweight/obese postmenopausal women. No synergistic effects were observed for DHA supplementation and RT-program combination. Full article

(This article belongs to the Special Issue Dietary Supplements and Musculoskeletal Health and Function)

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20 pages, 508 KiB

Open AccessArticle

Evaluating Mediterranean Diet-Adherent, Healthy and Allergen-Free Meals Offered in Tarragona Province Restaurants (Catalonia, Spain): A Cross-Sectional Study

by Floriana Mandracchia, Elisabet Llauradó, Rosa Maria Valls, Lucia Tarro and Rosa Solà

Nutrients 2021, 13(7), 2464; https://doi.org/10.3390/nu13072464 - 19 Jul 2021

Cited by 5 | Viewed by 3541

Abstract

Restaurant meal consumption has increased substantially, but the ability of restaurants to adhere to guidelines for the Mediterranean diet, healthiness and food allergen management is a challenge. This cross-sectional study aims to assess the Mediterranean diet adherence, healthiness, nutritional quality and food allergen [...] Read more.

Restaurant meal consumption has increased substantially, but the ability of restaurants to adhere to guidelines for the Mediterranean diet, healthiness and food allergen management is a challenge. This cross-sectional study aims to assess the Mediterranean diet adherence, healthiness, nutritional quality and food allergen management of meals at restaurants in the Tarragona province (Catalonia, Spain). Primary outcomes included adherence to criteria for the Mediterranean diet (AMed) and gluten management (SMAP), nutritional quality of dishes indicated by a green traffic light rating, meal nutrient content and allergen-free options. Secondary outcomes included restaurant staff knowledge about the Mediterranean diet and food allergens. Forty-four restaurants and 297 dishes were analysed. The restaurants fulfilled an average (mean ± SD) of 5.1 ± 1.6 of 9 compulsory AMed criteria and 12.9 ± 2.8 of 18 SMAP criteria. Dishes were mainly rated green for sugar (n = 178/297; 59.9%) but not for energy (n = 23/297; 7.7%) or total fat (n = 18/297; 6.1%). Waiters and cooks received passing scores for food allergen knowledge (5.8 ± 1.7 and 5.5 ± 1.5 out of 10 points, respectively). Restaurants partially met the AMed and SMAP criteria. Increasing fibre and decreasing saturated fat content are necessary to improve consumers’ adherence to healthy diets. For restaurant staff, training courses should be considered to improve their food allergen management. Full article

(This article belongs to the Section Nutrition Methodology & Assessment)

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17 pages, 12057 KiB

Open AccessArticle

Daily Rhythm of Fractal Cardiac Dynamics Links to Weight Loss Resistance: Interaction with CLOCK 3111T/C Genetic Variant

by Hui-Wen Yang, Marta Garaulet, Peng Li, Cristina Bandin, Chen Lin, Men-Tzung Lo and Kun Hu

Nutrients 2021, 13(7), 2463; https://doi.org/10.3390/nu13072463 - 19 Jul 2021

Cited by 2 | Viewed by 3133

Abstract

The effectiveness of weight loss treatment displays dramatic inter-individual variabilities, even with well-controlled energy intake/expenditure. This study aimed to determine the association between daily rhythms of cardiac autonomic control and weight loss efficiency and to explore the potential relevance to weight loss resistance [...] Read more.

The effectiveness of weight loss treatment displays dramatic inter-individual variabilities, even with well-controlled energy intake/expenditure. This study aimed to determine the association between daily rhythms of cardiac autonomic control and weight loss efficiency and to explore the potential relevance to weight loss resistance in humans carrying the genetic variant C at CLOCK 3111T/C. A total of 39 overweight/obese Caucasian women (20 CLOCK 3111C carriers and 19 non-carriers) completed a behaviour–dietary obesity treatment of ~20 weeks, during which body weight was assessed weekly. Ambulatory electrocardiographic data were continuously collected for up to 3.5 days and used to quantify the daily rhythm of fractal cardiac dynamics (FCD), a non-linear measure of autonomic function. FCD showed a 24 h rhythm (p < 0.001). Independent of energy intake and physical activity level, faster weight loss was observed in individuals with the phase (peak) of the rhythm between ~2–8 p.m. and with a larger amplitude. Interestingly, the phase effect was significant only in C carriers (p = 0.008), while the amplitude effect was only significant in TT carriers (p < 0.0001). The daily rhythm of FCD and CLOCK 3111T/C genotype is linked to weight loss response interactively, suggesting complex interactions between the genetics of the circadian clock, the daily rhythm of autonomic control, and energy balance control. Full article

(This article belongs to the Special Issue Chrononutrition and Chronic Diseases)

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11 pages, 255 KiB

Open AccessArticle

Fatty Acids Quality in Middle Eastern Traditional Dishes, Arabic Sweets and Market Foods Frequently Consumed in Lebanon

by Maha Hoteit, Edwina Zoghbi, Alissar Rady, Iman Shankiti and Ayoub Al-Jawaldeh

Nutrients 2021, 13(7), 2462; https://doi.org/10.3390/nu13072462 - 19 Jul 2021

Cited by 11 | Viewed by 3309

Abstract

The prevalence of diet-related non-communicable diseases is on the rise in the countries of the Eastern Mediterranean, including Lebanon. This study aimed to provide data on fatty acid profiles and ratios of Lebanese composite dishes, Arabic sweets, and market foods. Methods: Thirty types [...] Read more.

The prevalence of diet-related non-communicable diseases is on the rise in the countries of the Eastern Mediterranean, including Lebanon. This study aimed to provide data on fatty acid profiles and ratios of Lebanese composite dishes, Arabic sweets, and market foods. Methods: Thirty types of traditional dishes, collected from five different Lebanese governorates, thirty-seven types of Arabic sweets and forty-six market food products were considered for analysis. Food samples were chemically analyzed for total, unsaturated and saturated fatty acids. The range of total fatty acids in composite dishes, Arabic sweets, and market food products was between 1.2–11.7 g/100 g, 5.3–25.8 g/100 g, and 0.5–100 g/100 g, respectively. Additionally, the range of saturated fatty acids in composite dishes, Arabic sweets, and market food products was between 0.5–4.9 g/100 g, 2.5–23.6 g/100 g and 0.1–56.4 g/100 g, respectively. Furthermore, about 75% of these foods were poor in unsaturated fatty acids. Regarding saturated fatty acid, the polyunsaturated to monounsaturated (P.M.S) ratio was lower than the recommended ratio of 1:1:1 in 96% of samples. To conclude, there is a need to prioritize fat content in foods and consider processing modifications in the food production system with the aim of achieving a higher P:M:S ratio intake among the population. Full article

(This article belongs to the Special Issue Dietary Fat and Human Health Outcomes)

16 pages, 548 KiB

Open AccessArticle

Estimation of Dietary Capsaicinoid Exposure in Korea and Assessment of Its Health Effects

by Youngjoo Kwon

Nutrients 2021, 13(7), 2461; https://doi.org/10.3390/nu13072461 - 19 Jul 2021

Cited by 22 | Viewed by 4740

Abstract

The consumption of capsaicinoids, the active components in chili peppers, has been associated with both positive and negative health effects, and the level of capsaicinoid exposure may be an important determinant. Dietary capsaicinoid exposure was estimated using a previously developed database for capsaicinoid [...] Read more.

The consumption of capsaicinoids, the active components in chili peppers, has been associated with both positive and negative health effects, and the level of capsaicinoid exposure may be an important determinant. Dietary capsaicinoid exposure was estimated using a previously developed database for capsaicinoid content and a 24-h dietary recall dataset obtained from the Korea National Health and Nutrition Examination Survey. The estimated consumption level was evaluated to determine its potential effects on weight reduction and gastrointestinal distress. The estimated daily mean capsaicinoid intake was 3.25 mg (2.17 mg capsaicin), and most Koreans consumed 1–30 mg of capsaicinoids (0.67–20 mg capsaicin) in a day. No adverse effect of capsaicin consumption was reported other than abdominal pain. For long-term repeated consumption, 30 mg may be the maximum tolerable dose. However, the effects on body weight or energy balance were inconsistent in 4–12 week clinical studies conducted with various capsaicin doses (2–135 mg), which was likely due to the complex interplay between capsaicin dose, study length, and participant characteristics. Therefore, the capsaicin consumption of most Koreans was below the levels that may cause adverse effects. However, more long-term studies for the dose range of 2–20 mg are required to further characterize capsaicin’s health benefits in Koreans. Full article

(This article belongs to the Section Micronutrients and Human Health)

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18 pages, 2623 KiB

Open AccessReview

Effect of Low FODMAPs Diet on Irritable Bowel Syndromes: A Systematic Review and Meta-Analysis of Clinical Trials

by Jongsung Hahn, Jeongwon Choi and Min Jung Chang

Nutrients 2021, 13(7), 2460; https://doi.org/10.3390/nu13072460 - 19 Jul 2021

Cited by 19 | Viewed by 7285

Abstract

We conducted a meta-analysis exploring the effect of a low fermentable oligo-, di-, monosaccharides, and polyols diet (LFD) on the overall symptoms, quality of life, and stool habits of irritable bowel syndrome (IBS) patients. The meta-analysis was performed using a random-effects method. The [...] Read more.

We conducted a meta-analysis exploring the effect of a low fermentable oligo-, di-, monosaccharides, and polyols diet (LFD) on the overall symptoms, quality of life, and stool habits of irritable bowel syndrome (IBS) patients. The meta-analysis was performed using a random-effects method. The effect size was presented as weighted standardized mean difference (SMD) and 95% confidence interval (CI). Subgroup analyses were conducted to determine the potential effects of covariates on the outcome. Twenty-two papers were included. The LFD group showed a moderate reduction in symptom severity and a slight improvement in quality of life compared to the control group (SMD, −0.53 and 0.24; 95% CI, −0.68, −0.38 and 0.02, 0.47, respectively). IBS symptom improvement was consistent between subgroups stratified according to proportions of female patients, study durations, IBS subtypes, assessment methods, and control interventions. Three studies regarding stool habits change in IBS-D patients showed a significant decrease in stool frequency (mean differences [MD], −5.56/week; 95% CI, −7.40, −3.72) and a significant improvement in stool consistency (MD, −0.86; 95% CI, −1.52, −0.19) in the LFD group compared to the control group. This is the most updated meta-analysis including studies that adopted diverse control interventions such as dietary interventions, supplementation, habitual diets, and lifestyle changes. Full article

(This article belongs to the Section Clinical Nutrition)

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12 pages, 308 KiB

Open AccessReview

The Emerging Role of Sfrp5 and Wnt5a in the Pathogenesis of Obesity: Implications for a Healthy Diet and Lifestyle

by Diamanto Koutaki, Athanasios Michos, Flora Bacopoulou and Evangelia Charmandari

Nutrients 2021, 13(7), 2459; https://doi.org/10.3390/nu13072459 - 19 Jul 2021

Cited by 18 | Viewed by 4352

Abstract

In recent decades, the prevalence of obesity has risen dramatically worldwide among all age groups. Obesity is characterized by excess fat accumulation and chronic low-grade inflammation. The adipose tissue functions as a metabolically active endocrine organ secreting adipokines. A novel duo of adipokines, [...] Read more.

In recent decades, the prevalence of obesity has risen dramatically worldwide among all age groups. Obesity is characterized by excess fat accumulation and chronic low-grade inflammation. The adipose tissue functions as a metabolically active endocrine organ secreting adipokines. A novel duo of adipokines, the anti-inflammatory secreted frizzled-related protein 5 (Sfrp5) and the proinflammatory wingless type mouse mammary tumor virus (MMTV) integration site family member 5A (Wnt5a), signal via the non-canonical Wnt pathway. Recent evidence suggests that Sfpr5 and Wnt5a play a key role in the pathogenesis of obesity and its metabolic complications. This review summarizes the current knowledge on the novel regulatory system of anti-inflammatory Sfrp5 and pro-inflammatory Wnt5a, and their relation to obesity and obesity-related complications. Future studies are required to investigate the potential role of Sfrp5 and Wnt5a as biomarkers for monitoring the response to lifestyle interventions and for predicting the development of cardiometabolic risk factors. These adipokines may also serve as novel therapeutic targets for obesity-related disorders. Full article

(This article belongs to the Special Issue Nutrition and Endocrine Disorders)

7 pages, 216 KiB

Open AccessCommunication

Perceived Facilitators and Barriers to Engaging with a Digital Intervention among Those with Food Insecurity, Binge Eating, and Obesity

by Anu Venkatesh, Angela Chang, Emilie A. Green, Tianna Randall, Raquel Gallagher, Jennifer E. Wildes and Andrea K. Graham

Nutrients 2021, 13(7), 2458; https://doi.org/10.3390/nu13072458 - 19 Jul 2021

Cited by 8 | Viewed by 3543

Abstract

Interventions that address binge eating and food insecurity are needed. Engaging people with lived experience to understand their needs and preferences could yield important design considerations for such interventions. In this study, people with food insecurity, recurrent binge eating, and obesity completed an [...] Read more.

Interventions that address binge eating and food insecurity are needed. Engaging people with lived experience to understand their needs and preferences could yield important design considerations for such interventions. In this study, people with food insecurity, recurrent binge eating, and obesity completed an interview-based needs assessment to learn facilitators and barriers that they perceive would impact their engagement with a digital intervention for managing binge eating and weight. Twenty adults completed semi-structured interviews. Responses were analyzed using thematic analysis. Three themes emerged. Participants shared considerations that impact their ability to access the intervention (e.g., cost of intervention, cost of technology, accessibility across devices), ability to complete intervention recommendations (e.g., affordable healthy meals, education to help stretch groceries, food vouchers, rides to grocery stores, personalized to budget), and preferred intervention features for education, self-monitoring, personalization, support, and motivation/rewards. Engaging people with lived experiences via user-centered design methods revealed important design considerations for a digital intervention to meet this population’s needs. Future research is needed to test whether a digital intervention that incorporates these recommendations is engaging and effective for people with binge eating and food insecurity. Findings may have relevance to designing digital interventions for other health problems as well. Full article

(This article belongs to the Special Issue Innovative Food and Nutrition Approaches to Promote Healthy Lifestyles and Reduce Disparities)

17 pages, 1348 KiB

Open AccessArticle

TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

by Efrosini Tsirou, Maria G. Grammatikopoulou, Meletios P. Nigdelis, Eleftheria Taousani, Dimitra Savvaki, Efstratios Assimakopoulos, Apostolos Tsapas and Dimitrios G. Goulis

Nutrients 2021, 13(7), 2457; https://doi.org/10.3390/nu13072457 - 18 Jul 2021

Cited by 10 | Viewed by 3988

Abstract

Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate [...] Read more.

Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate the effect of a very low energy diet (VLED, 1600 kcal/day), or a low energy diet (LED, 1800 kcal/day), with or without personalized exercise sessions, among women with GDM in singleton pregnancies. A total of 43 women were allocated to one of four interventions at GDM diagnosis: (1) VLED (n = 15), (2) VLED + exercise (n = 4), (3) LED (n = 16) or (4) LED + exercise (n = 8). Primary outcomes were gestational weight gain (GWG), infant birth weight, complications at delivery and a composite outcomes score. Secondary outcomes included type of delivery, prematurity, small- for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, macrosomia, Apgar score, insulin use, depression, respiratory quotient (RQ), resting metabolic rate (RMR) and middle-upper arm circumference (MUAC). GWG differed between intervention groups (LED median: 12.0 kg; VLED: 5.9 kg). No differences were noted in the type of delivery, infant birth weight, composite score, prevalence of prematurity, depression, RQ, Apgar score, MUAC, or insulin use among the four groups. Regarding components of the composite score, most infants (88.4%) were appropriate-for-gestational age (AGA) and born at a gestational age of 37–42 weeks (95.3%). With respect to the mothers, 9.3% experienced complications at delivery, with the majority being allocated at the VLED + exercise arm (p < 0.03). The composite score was low (range 0–2.5) for all mother-infant pairs, indicating a “risk-free” pregnancy outcome. The results indicate that adherence to a LED or VLED induces similar maternal, infant and obstetrics outcomes. Full article

(This article belongs to the Special Issue Advances in the Nutrition of Diabetes and Gestational Diabetes)

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10 pages, 480 KiB

Open AccessArticle

Intake of Vegetables, Fruits and Berries and Compliance to “Five-a-Day” in a General Norwegian Population—The Tromsø Study 2015–2016

by Linn Nilsen, Laila A. Hopstock, Sameline Grimsgaard, Monica Hauger Carlsen and Marie W. Lundblad

Nutrients 2021, 13(7), 2456; https://doi.org/10.3390/nu13072456 - 18 Jul 2021

Cited by 5 | Viewed by 3173

Abstract

Vegetables, fruits and berries are associated with reduced disease risk, and recommended intake is “five-a-day”. We studied the intake of vegetables, fruits and berries and compliance with “five-a-day” in 11,425 adults (40–96 years) who completed a food frequency questionnaire in the seventh wave [...] Read more.

Vegetables, fruits and berries are associated with reduced disease risk, and recommended intake is “five-a-day”. We studied the intake of vegetables, fruits and berries and compliance with “five-a-day” in 11,425 adults (40–96 years) who completed a food frequency questionnaire in the seventh wave of the Tromsø Study (2015–2016). Intake and proportion above/below recommended intake (250 g/day of vegetables and 250 g/day of fruits/berries, combined and separately) were analyzed. Logistic regression was used to examine compliance with recommendations in 10-year age-groups, and level of education, body mass index (BMI) and physical activity, in strata of sex and adjusted for total energy. Median intake of vegetables was 228 and 168 g/day, and fruits/berries 292 and 268 g/day, in women and men, respectively. In total, 31% of women and 17% of men met the five-a-day recommendation, and 44% and 60% of women, and 25% and 54% of men, met the recommendation for vegetables and fruits/berries, respectively. Odds of compliance with recommendation for both vegetables and fruits/berries were positively associated with age, education and physical activity (p trend < 0.001). The intake of vegetables, fruits and berries was suboptimal, in particular for vegetables. More women than men met the recommendation, and intake varied by education, physical activity level, age and BMI. Full article

(This article belongs to the Section Nutrition and Public Health)

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18 pages, 1162 KiB

Open AccessReview

Promising Anticancer Activities of Alismatis rhizome and Its Triterpenes via p38 and PI3K/Akt/mTOR Signaling Pathways

by Eungyeong Jang and Jang-Hoon Lee

Nutrients 2021, 13(7), 2455; https://doi.org/10.3390/nu13072455 - 18 Jul 2021

Cited by 16 | Viewed by 3410

Abstract

The flowering plant genus Alisma, which belongs to the family Alismataceae, comprises 11 species, including Alisma orientale, Alisma canaliculatum, and Alisma plantago-aquatica. Alismatis rhizome (Ze xie in Chinese, Takusha in Japanese, and Taeksa in Korean, AR), [...] Read more.

The flowering plant genus Alisma, which belongs to the family Alismataceae, comprises 11 species, including Alisma orientale, Alisma canaliculatum, and Alisma plantago-aquatica. Alismatis rhizome (Ze xie in Chinese, Takusha in Japanese, and Taeksa in Korean, AR), the tubers of medicinal plants from Alisma species, have long been used to treat inflammatory diseases, hyperlipidemia, diabetes, bacterial infection, edema, oliguria, diarrhea, and dizziness. Recent evidence has demonstrated that its extract showed pharmacological activities to effectively reverse cancer-related molecular targets. In particular, triterpenes naturally isolated from AR have been found to exhibit antitumor activity. This study aimed to describe the biological activities and plausible signaling cascades of AR and its main compounds in experimental models representing cancer-related physiology and pathology. Available in vitro and in vivo studies revealed that AR extract possesses anticancer activity against various cancer cells, and the efficacy might be attributed to the cytotoxic and antimetastatic effects of its alisol compounds, such as alisol A, alisol B, and alisol B 23-acetate. Several beneficial functions of triterpenoids found in AR might be due to p38 activation and inhibition of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathways. Moreover, AR and its triterpenes inhibit the proliferation of cancer cells that are resistant to chemotherapy. Thus, AR and its triterpenes may play potential roles in tumor attack, as well as a therapeutic remedy alone and in combination with other chemotherapeutic drugs. Full article

(This article belongs to the Section Phytochemicals and Human Health)

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15 pages, 1390 KiB

Open AccessArticle

A Double-Blind, Randomized, Placebo-Controlled Trial to Evaluate the Efficacy of a Hydrolyzed Chicken Collagen Type II Supplement in Alleviating Joint Discomfort

by Anaam Mohammed and Siran He

Nutrients 2021, 13(7), 2454; https://doi.org/10.3390/nu13072454 - 18 Jul 2021

Cited by 9 | Viewed by 9338

Abstract

Joint pain and disease affects more than one in four adults in the United States. We conducted a double-blind, randomized, placebo-controlled trial to investigate the efficacy of a hydrolyzed chicken collagen type II (HCII) supplement in reducing joint-related discomfort such as pain and [...] Read more.

Joint pain and disease affects more than one in four adults in the United States. We conducted a double-blind, randomized, placebo-controlled trial to investigate the efficacy of a hydrolyzed chicken collagen type II (HCII) supplement in reducing joint-related discomfort such as pain and stiffness, and in improving mobility. We enrolled adults aged 40–65 (65.5% were women) who had joint discomfort, but had no co-morbidities, and who were not taking pain medications. The participants were randomized to receive either the HCII supplement (n = 47) or a placebo (n = 43) for eight weeks. At the baseline, and at week 4 and week 8, we administered the Western Ontario and McMaster Universities Arthritis Index (WOMAC) survey with three additional wrist-related questions and the Visual Analog Scale for assessments of joint-related symptoms. In the WOMAC stiffness and physical activity domains and in the overall WOMAC score, the HCII group had a significant reduction in joint-related discomforts compared with the placebo group. For example, at week 4, the HCII group had a 36.9% reduction in the overall WOMAC score, compared with a 14.3% reduction in the placebo group (p = 0.027). This HCII product is effective in reducing joint pain and stiffness and in improving joint function among otherwise healthy adults. Full article

(This article belongs to the Section Proteins and Amino Acids)

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17 pages, 880 KiB

Open AccessFeature PaperArticle

Heart Rate Variability and Long Chain n-3 Polyunsaturated Fatty Acids in Chronic Kidney Disease Patients on Haemodialysis: A Cross-Sectional Pilot Study

by Ana M Pinto, Helen L MacLaughlin and Wendy L Hall

Nutrients 2021, 13(7), 2453; https://doi.org/10.3390/nu13072453 - 18 Jul 2021

Cited by 3 | Viewed by 3769

Abstract

Low heart rate variability (HRV) is independently associated with increased risk of sudden cardiac death (SCD) and all cardiac death in haemodialysis patients. Long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) may exert anti-arrhythmic effects. This study aimed to investigate [...] Read more.

Low heart rate variability (HRV) is independently associated with increased risk of sudden cardiac death (SCD) and all cardiac death in haemodialysis patients. Long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) may exert anti-arrhythmic effects. This study aimed to investigate relationships between dialysis, sleep and 24 h HRV and LC n-3 PUFA status in patients who have recently commenced haemodialysis. A cross-sectional study was conducted in adults aged 40–80 with chronic kidney disease (CKD) stage 5 (n = 45, mean age 58, SD 9, 20 females and 25 males, 39% with type 2 diabetes). Pre-dialysis blood samples were taken to measure erythrocyte and plasma fatty acid composition (wt % fatty acids). Mean erythrocyte omega-3 index was not associated with HRV following adjustment for age, BMI and use of β-blocker medication. Higher ratios of erythrocyte eicosapentaenoic acid (EPA) to docosahexaenoic acid (DHA) were associated with lower 24 h vagally-mediated beat-to-beat HRV parameters. Higher plasma EPA and docosapentaenoic acid (DPAn-3) were also associated with lower sleep-time and 24 h beat-to-beat variability. In contrast, higher plasma EPA was significantly related to higher overall and longer phase components of 24 h HRV. Further investigation is required to investigate whether patients commencing haemodialysis may have compromised conversion of EPA to DHA, which may impair vagally-mediated regulation of cardiac autonomic function, increasing risk of SCD. Full article

(This article belongs to the Special Issue Dietary Fat and Human Health Outcomes)

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18 pages, 832 KiB

Open AccessFeature PaperReview

Nutrition Strategy and Life Style in Polycystic Ovary Syndrome—Narrative Review

by Małgorzata Szczuko, Justyna Kikut, Urszula Szczuko, Iwona Szydłowska, Jolanta Nawrocka-Rutkowska, Maciej Ziętek, Donatella Verbanac and Luciano Saso

Nutrients 2021, 13(7), 2452; https://doi.org/10.3390/nu13072452 - 18 Jul 2021

Cited by 71 | Viewed by 43190

Abstract

Here we present an extensive narrative review of the broadly understood modifications to the lifestyles of women with polycystic ovary syndrome (PCOS). The PubMed database was analyzed, combining PCOS entries with causes, diseases, diet supplementation, lifestyle, physical activity, and use of herbs. The [...] Read more.

Here we present an extensive narrative review of the broadly understood modifications to the lifestyles of women with polycystic ovary syndrome (PCOS). The PubMed database was analyzed, combining PCOS entries with causes, diseases, diet supplementation, lifestyle, physical activity, and use of herbs. The metabolic pathways leading to disturbances in lipid, carbohydrate, and hormonal metabolism in targeted patients are described. The article refers to sleep disorders, changes in mental health parameters, and causes of oxidative stress and inflammation. These conditions consistently lead to the occurrence of severe diseases in patients suffering from diabetes, the fatty degeneration of internal organs, infertility, atherosclerosis, cardiovascular diseases, dysbiosis, and cancer. The modification of lifestyles, diet patterns and proper selection of nutrients, pharmacological and natural supplementation in the form of herbs, and physical activity have been proposed. The progress and consequences of PCOS are largely modifiable and depend on the patient’s approach, although we have to take into account also the genetic determinants. Full article

(This article belongs to the Special Issue Nutrition in Gynecologic Disease)

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Open AccessArticle

Whey Protein Supplementation Improves the Glycemic Response and May Reduce Non-Alcoholic Fatty Liver Disease Related Biomarkers in Women with Polycystic Ovary Syndrome (PCOS)

by Emily L. Zumbro, Manisha Rao, Shenavia Balcom-Luker, K. Shane Broughton and Monique J. LeMieux

Nutrients 2021, 13(7), 2451; https://doi.org/10.3390/nu13072451 - 17 Jul 2021

Cited by 7 | Viewed by 8391

Abstract

Polycystic ovary syndrome (PCOS) increases type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) with insulin resistance. We hypothesized that a 35 g whey preload would improve insulin sensitivity and glucose handling while reducing biomarkers associated with NAFLD. Twenty-nine age-matched women (CON = [...] Read more.

Polycystic ovary syndrome (PCOS) increases type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) with insulin resistance. We hypothesized that a 35 g whey preload would improve insulin sensitivity and glucose handling while reducing biomarkers associated with NAFLD. Twenty-nine age-matched women (CON = 15, PCOS = 14) completed oral glycemic tolerance tests following baseline (Day 0) as well as an acute (Day 1) and short-term whey supplementation (Day 7). Whey had an interaction effect on glucose (p = 0.02) and insulin (p = 0.03), with glucose remaining stable and insulin increasing with whey supplementation. Insulin sensitivity (p < 0.01) improved with whey associated with increased glucagon secretion (p < 0.01). Alanine aminotransferase (ALT), and aspartate aminotransferase (AST) remained unchanged, but “day” had an effect on the AST:ALT ratio (p = 0.04), whereas triglycerides and sex hormone binding globulin overall were greater in the PCOS group (p < 0.05). Total cholesterol decreased in PCOS (by 13%) and CON (by 8%) (NS). HepG2 cells treated with plasma from participants before and after whey decreased lipid accumulation in the PCOS group after whey (p < 0.05). Whey provided an insulinogenic and glycemic homeostatic effect in women with PCOS with the potential to combat NAFLD-consequences. Full article

(This article belongs to the Section Nutrition in Women)

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