Test Drink Research Articles

Comparison of Intraocular Pressure After Water Drinking Test in Primary Open Angle Glaucoma Patients Controlled with Latanoprost and Trabeculectomy

Purpose: To compare intraocular pressure (IOP) after water drinking test in primary open angle glaucoma patients controlled with latanoprost 0.005% and trabeculectomy.Methods: Observational study with cross-sectional design of 28 eyes with primary open angle glaucoma (POAG) patients. Subjects were divided into two groups, 14 patients controlled with trabeculectomy and 14 patients with latanoprost monotherapy. All subjects were under clinical therapy and had an intraocular pressure (IOP) equal or lower than 18 mm Hg, monitored during the follow up period. All subjects were submitted to the water drinking test. The results of the water drinking test, which were peak and fluctuation of IOP, were then compared between groups. Results: There were no significant difference between IOP peak between two groups (p=0.88). IOP fluctuation also showed no significant difference between groups (p=0.84). In both groups, baseline IOP strongly correlated with peak IOP in water drinking test with correlation coefficient r=0.96 (p<0.001) and r=0.71 (p=0.04), while baseline IOP in trabeculectomy group was strongly correlated with IOP fluctuation with correlation coefficient r=0.86 (p<0.001). Conclusions: Peak and fluctuation of IOP after water drinking test in primary open angle patients controlled with latanoprost and trabeculectomy showed no significant difference.

The Timed Swallowing Proficiency for Eating and Drinking (SPEAD) Test: Development and Initial Validation of an Instrument to Objectify (Impaired) Swallowing Capacity in Head and Neck Cancer Patients.

Objective swallowing outcomes measure the physical swallowing function, while subjective outcomes measure swallowing perception. A test for swallowing capacity, measuring the ingestion of all consistencies is currently not available. Therefore, the Swallowing Proficiency for Eating And Drinking (SPEAD) test was developed. It entails the timed ingestion of thin liquid, thick liquid and solid. In this study, its feasibility, reliability and validity were evaluated in patients with dysphagia after treatment for head and neck cancer (HNC) and healthy participants. Thirty-eight HNC patients and forty healthy participants were enrolled in this study and performed the SPEAD test three times. Video recordings of the test were evaluated three times by one observer, and once by three additional observers, to assess test-retest, intra-rater and inter-rater reliability. Validity was assessed by calculating effect sizes for the difference between results of patients and healthy participants and by evaluating correlations with objective (e.g., videofluoroscopy and functional oral intake scale) and subjective (e.g., SWAL-QOL) swallowing outcomes. Test-retest, intra-rater and inter-rater reliability of ingestion duration was good to excellent. All hypotheses with regard to magnitude and direction of correlations were confirmed, supporting construct validity of the test. Our initial results suggest that the SPEAD test reliably measures the transport capacity of the upper digestive tract (in grams per second) and that this test can be useful to objectively evaluate and monitor the (safe) swallowing capacity in HNC patients, in both research as well as daily clinical practice.

Evaluating the Efficacy of VitalStim Electrical Stimulation Combined with Swallowing Function Training for Treating Dysphagia following an Acute Stroke

OBJECTIVES:This study explored the clinical efficacy of VitalStim electrical stimulation combined with swallowing function training for patients with dysphagia following an acute stroke.METHODS:Seventy-two patients with dysphagia following an acute stroke were admitted to our hospital and were further divided into two groups using prospective research methods. There were 36 cases in each group according to the random number table method. The control group received conventional medical treatment and swallowing function training while the experimental group received conventional medical treatment and VitalStim electrical stimulation combined with swallowing function training.RESULTS:The overall response rate of the experimental group (94.44%) was higher than that of the control group (77.78%), and the difference was statistically significant (p<0.05). Compared with before treatment, the upward and forward movement speeds of the hyoid bone, anterior movement speed, the grading score of the Kubota drinking water test, Caiteng’s grading score, serum superoxide dismutase, 5-hydroxytryptamine, and norepinephrine levels, Fugl-Meyer Assessment score, and multiple quality of life scores of the two groups showed improvement after treatment. While the standard swallowing assessment score, serum malondialdehyde level, and National Institutes of Health Stroke Scale score decreased, the aforementioned indices showed a significant improvement in the experimental group (p<0.05).CONCLUSION:The results of this study indicate that VitalStim electrical stimulation combined with swallowing function is effective for treating dysphagia following an acute stroke. It can effectively improve swallowing, neurological, and limb motor functions, reduce complications, promote physical recovery, and improve overall quality of life of patients.

Effect of an Enriched Protein Drink on Muscle Mass and Glycemic Control during Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes: A Double-Blind RCT.

Background: Weight loss is key to treatment of older adults with obesity and type 2 diabetes, but also a risk for muscle mass loss. This study investigated whether a whey protein drink enriched with leucine and vitamin D could preserve muscle mass and improve glycemic control during combined lifestyle intervention in this population. Methods: 123 older adults with obesity and type 2 diabetes were randomized into a 13-week lifestyle intervention with dietary advice and exercise, receiving either the enriched protein drink (test) or an isocaloric control (control). Muscle mass was assessed with dual-energy X-ray absorptiometry and glycemic control by oral glucose tolerance test. Statistical analyses were performed using a linear mixed model. Results: There was a nonsignificant increase in leg muscle mass (+0.28 kg; 95% CI, −0.01 to 0.56) and a significant increase in appendicular muscle mass (+0.36 kg; 95% CI, 0.005 to 0.71) and total lean mass (+0.92 kg; 95% CI, 0.19 to 1.65) in test vs. control. Insulin sensitivity (Matsuda index) also increased in test vs. control (+0.52; 95% CI, 0.07 to 0.97). Conclusions: Use of an enriched protein drink during combined lifestyle intervention shows beneficial effects on muscle mass and glycemic control in older adults with obesity and type 2 diabetes.

Appetite Control across the Lifecourse: The Acute Impact of Breakfast Drink Quantity and Protein Content. The Full4Health Project.

Understanding the mechanisms of hunger, satiety and how nutrients affect appetite control is important for successful weight management across the lifecourse. The primary aim of this study was to describe acute appetite control across the lifecourse, comparing age groups (children, adolescents, adults, elderly), weight categories, genders and European sites (Scotland and Greece). Participants (n = 391) consumed four test drinks, varying in composition (15% (normal protein, NP) and 30% (high protein, HP) of energy from protein) and quantity (based on 100% basal metabolic rate (BMR) and 140% BMR), on four separate days in a double-blind randomized controlled study. Ad libitum energy intake (EI), subjective appetite and biomarkers of appetite and metabolism (adults and elderly only) were measured. The adults’ appetite was significantly greater than that of the elderly across all drink types (p < 0.004) and in response to drink quantities (p < 0.001). There were no significant differences in EI between age groups, weight categories, genders or sites. Concentrations of glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) were significantly greater in the elderly than the adults (p < 0.001). Ghrelin and fasting leptin concentrations differed significantly between weight categories, genders and sites (p < 0.05), while GLP-1 and PYY concentrations differed significantly between genders only (p < 0.05). Compared to NP drinks, HP drinks significantly increased postprandial GLP-1 and PYY (p < 0.001). Advanced age was concomitant with reduced appetite and elevated anorectic hormone release, which may contribute to the development of malnutrition. In addition, appetite hormone concentrations differed between weight categories, genders and geographical locations.

Effects of Matcha Green Tea Powder on Cognitive Functions of Community-Dwelling Elderly Individuals.

Matcha Green Tea Powder contains a variety of active ingredients beneficial to health, such as tea catechins, lutein and vitamin K. It is also known that these ingredients confer benefits upon cognitive functions of elderly people. Therefore, we aimed to investigate the relationship between a daily supplementation of Matcha and the change in cognitive functions of community-dwelling elderly people. A randomized, double-blind, placebo-controlled 12-week trial was performed. Sixty-one participants were recruited and randomly assigned to receive test drink containing 3 g powder from fresh Matcha or placebo powder per day. Changes in cognitive function were assessed utilizing a psychometric test battery. Daily food intake was assessed by a Brief-type Self-administered Diet History Questionnaire (BDHQ). In the gender-specific analysis, a significant cognitive enhancement was observed in the Montreal Cognitive Assessment (MoCA) score in the active group of women. In dietary analysis, we found a significant inverse correlation between consumption of vitamin K in daily diet, excluding test drinks, and change in MoCA. The present study suggests that daily supplementation of Matcha Green Tea Powder has protective effects against cognitive decline in community-dwelling elderly women.

Evaluation of endoscopic ultrasound-guided gastric botulinum toxin injections in the treatment of obesity

BackgroundObesity is rapidly emerging as one of the greatest challenges of human health. Many randomized trials and open-label human studies described conflicting results of gastric intra-muscular injections of botulinum toxin type A (BTA). Endoscopic ultrasound (EUS) guidance can assure BTA injection into the subserosal layer and muscularis propria of the gastric wall which may optimize the efficacy of injection. The aim of the study is to assess the efficacy and safety of EUS-guided gastric BTA injections in weight reduction for obese subjects.ResultsThe present study included 25 patients (2 males and 23 females with mean age 35.84 ± 7.776). For nutrient drink tests, median maximum tolerated volumes (MTVs) decreased from 720 cc (range 480–1680) as a baseline value 2 weeks before BTA injection to 360 cc (range 140–820) at 16 weeks after injection. Mean body weight reduction was 11.92 kg (10.8%) after 16 weeks of BTA injection. Mean body weight continued to decrease during the study period from a baseline value of 110 to 98 kg with significant reduction of mean BMI from baseline value of 41.2 to 36.7 at 16 weeks after BTA injection (p < 0.001). The study was completed without major adverse events.ConclusionEUS-guided BTA injection into the antral subserosa and muscularis propria could be an effective technique for weight reduction, or as a bridge for surgery, which can be done safely with minimal complications.Trial registrationNCT03901040

Functional Deficits in Gut Microbiome of Young and Middle-Aged Adults with Prediabetes Apparent in Metabolizing Bioactive (Poly)phenols.

Background: Gut microbiota metabolize select dietary (poly)phenols to absorbable metabolites that exert biological effects important in metabolic health. Microbiota composition associated with health/disease status may affect its functional capacity to yield bioactive metabolites from dietary sources. Therefore, this study assessed gut microbiome composition and its related functional capacity to metabolize fruit (poly)phenols in individuals with prediabetes and insulin resistance (PreDM-IR, n = 26) compared to a metabolically healthy Reference group (n = 10). Methods: Shotgun sequencing was used to characterize gut microbiome composition. Targeted quantitative metabolomic analyses of plasma and urine collected over 24 h were used to assess microbial-derived metabolites in response to a (poly)phenol-rich raspberry test drink. Results: PreDM-IR compared to the Reference group: (1) enriched Blautia obeum and Blautia wexlerae and depleted Bacteroides dorei and Coprococcus eutactus. Akkermansia muciniphila and Bacteroides spp. were depleted in the lean PreDM-IR subset; and (2) impaired microbial catabolism of select (poly)phenols resulting in lower 3,8-dihydroxy-urolithin (urolithin A), phenyl-γ-valerolactones and various phenolic acids concentrations (p < 0.05). Controlling for obesity revealed relationships with microbial species that may serve as metagenomic markers of diabetes development and therapeutic targets. Conclusions: Data provide insight from multi-omics approaches to advance knowledge at the diet–gut–disease nexus serving as a platform for devising dietary strategies to improve metabolic health.

Influence of Trehalose Mouth Rinse on Anaerobic and Aerobic Exercise Performance

Trehalose is a disaccharide consisting of 2 glucose units linked in an alpha 1,1-glycosidic bond. Pre-exercise trehalose ingestion enhances exercise performance within 30 minutes. Enhanced performance was hypothesized to be due to a mouth rinse effect. A 3-arm double-blind crossover trial was conducted to test this hypothesis. Ten healthy male collegiate distance runners rinsed their mouths with either trehalose (6% w/v) or maltose (6% w/v) or acesulfame potassium (0.04 mg/mL) for 5 seconds and then performed an exercise assessment composed of 6-second peak power and endurance tests. Trehalose induced the highest mean power output ( P &lt; .01) in peak power tests. In the endurance test, trehalose consistently showed higher mean power output than maltose. The 3 test drinks displayed indistinguishable sweetness and were expected to activate receptors for sweetness (T1R2-T1R3) with the same intensity. Trehalose activates taste receptors T1R1-T1R3, T1R3-T1R3 homodimer, and T1R2-T1R3, whereas sucrose activates only T1R2-T1R3. Therefore, a difference in mouth rinse effect might be due to a specific receptor in the oral cavity that recognizes differences between trehalose and maltose.

Plasma and Urinary (Poly)phenolic Profiles after 4-Week Red Raspberry (Rubus idaeus L.) Intake with or without Fructo-Oligosaccharide Supplementation.

Red raspberries (RRB) are high in anthocyanin- and ellagitannin- type (poly)phenols. This study aimed to investigate the effect of 4-week RRB supplementation on (poly)phenolic metabolism in adults with prediabetes and insulin-resistance (PreDM-IR); and whether adding fructo-oligosaccharides (FOS), prebiotics, would augment the microbial metabolites of RRB (poly)phenols. In a randomized crossover clinical trial, subjects (n = 35: PreDM-IR, n = 25; healthy Reference group, n = 10) consumed 1 cup RRB (fresh weight equivalence) per day and RRB with 8 g FOS per day each for 4 weeks in random order separated by 4-week washout. Plasma and urinary (poly)phenolic metabolites were characterized after (0–24 h) consuming a RRB-based test drink (2 cups RRB) at baseline/week 0 and again after 4-week supplementations. A total of 123 (poly)phenolic metabolites were quantified. After 4-week RRB supplementation, several metabolite groups were significantly increased (p < 0.05), including urolithins, phenyl-γ-valerolactones, and phenolic acids. Supplementing FOS with RRB for 4 weeks enhanced benzoic acid derivatives compared to the baseline (p < 0.05). Specific effects of supplementation by metabolic status indicated 4-week RRB supplementation significantly increased microbial metabolites that were lower in PreDM-IR group. Our results suggest alterations in the capacity of PreDM-IR group to metabolize and render bioavailable raspberry-derived (poly)phenols when consumed regularly.

Acute effects of whey protein on energy intake, appetite and gastric emptying in younger and older, obese men

BackgroundObesity is becoming more prevalent in older people. A management strategy in obese, young adults is to increase dietary protein relative to other macronutrients. It is not clear if this is effective in obese, older individuals. Obesity may be associated with diminished sensitivity to nutrients. We have reported that a 30-g whey protein drink slows gastric emptying more, and suppresses energy intake less, in older, than younger, non-obese men. The aim of this study was to determine the effect of a 30 g whey protein drink on energy intake, GE and glycaemia in obese, older and younger men.MethodsIn randomized, double-blind order, 10 younger (age: 27 ± 2 years; BMI: 36 ± 2 kg/m²), and 10 older (72 ± 1 years; 33 ± 1 kg/m²), obese men were studied twice. After an overnight fast, subjects ingested a test drink containing 30 g whey protein (120 kcal) or control (2 kcal). Postprandial gastric emptying (antral area, 2D Ultrasound) and blood glucose concentrations were measured for 180 min. At t = 180 min subjects were given a buffet meal and ad libitum energy intake was assessed.ResultsOlder subjects ate non-significantly less (~20%) that the younger subjects (effect of age, P = 0.16). Whey protein had no effect on subsequent energy intake (kcal) compared to control in either the younger (decrease 3 ± 8%) or older (decrease 2 ± 8%) obese men (age effect P > 0.05, protein effect P = 0.46, age × protein interaction effect P = 0.84). Whey protein slowed gastric emptying, to a similar degree in both age groups (50% emptying time: control vs. protein young men: 255 ± 5 min vs. 40 ± 7 min; older men: 16 ± 5 min vs. 50 ± 8 min; protein effect P = 0.001, age effect P = 0.93, age × protein interaction effect P = 0.13).ConclusionsOur data suggest that obesity may blunt/abolish the age-related effect of whey protein on suppression of energy intake.

Functional dyspepsia in children: A study of pathophysiological factors.

Functional dyspepsia (FD) is common in children, and treatment targeted towards the altered pathophysiology can improve outcome. We evaluated FD children for abnormality of gastric accommodation and emptying, psychological stressors (PS), Helicobacter pylori (HP) infection, and post-infectious FD. Diagnosis of FD was based on ROME III criteria. Clinical evaluation including dyspeptic symptom scoring and assessment for PS was performed. Satiety drink test for gastric accommodation, gastroscopy with biopsy for HP infection, and solid meal gastric emptying were performed. Sixty-seven healthy children were enrolled for assessing PS and satiety drink test. Fifty-five FD children (33 boys, age 12 [6-18] years) with symptoms for 4 (2-48) months and dyspeptic score of 5 (1-13) were enrolled. PS were more common in FD than in controls (46/55 vs 9/67; P<0.001). Median satiety drink volume was 360mL (180-1320mL); no patients had satiety drink volume of <5th centile of healthy children. The frequency (98% vs 85%; P=0.01) and severity (65 [10-175] vs 50 [5-130]; P<0.001) of postprandial symptoms were higher in FD than in controls. Of the postprandial symptoms, pain (20.3% vs 0%; P=0.000) was present only in FD. Delayed gastric emptying was present in 6.5%, HP infection in 11%, and post-infectious FD in 13% cases. Etiological factor was identified in 87% children, with 20% having multiple factors. Abnormality of gastric sensorimotor function is seen in one-fourth of FD cases. HP infection and post-infectious FD are present in 11% and 13% cases, respectively.

Intraocular Pressure Changes after Water Drinking Test in Surgically Treated Primary Congenital Glaucoma.

PurposeTo assess intraocular pressure (IOP) changes after the water drinking test (WDT) in patients with primary congenital glaucoma (PCG).MethodsIn this prospective interventional study, 20 eyes of 20 patients with PCG were included. All patients had undergone trabeculotomy. Six out of twenty eyes had received a glaucoma drainage device (GDD) implantation. IOP was measured using an air-puff tonometer at baseline, and 15, 30, 45, and 60 min after WDT. The repeated-measures analysis of variance test was used to compare the mean IOPs at different time points.Results The mean ( standard deviation) of participants' age was 9.9 2.7 years (range, 6 to 16 years), and 8 (40%) participants were male. The mean IOPs at baseline and 15, 30, 45, and 60 minutes after the WDT were 15.8 3.7, 18.6 3.4, 19.0 3.8, 17.9 3.8, and 16.9 3.5 mmHg, respectively (P 0.001). Pairwise comparisons revealed that the mean IOPs after 15 and 30 min were significantly greater than the baseline IOP (P 0.001 and P = 0.002, respectively); however, the difference in mean IOPs after 45 and 60 min were not statistically significant from the baseline IOP. The averages of IOP peak and IOP fluctuation after the WDT were 20.0 3.5 and 4.2 2.9 mmHg, respectively. IOP fluctuation in those who underwent trabeculotomy alone was twice that of those with GDDs, but the difference was not statistically significant (5.0 vs 2.5 mmHg; P = 0.08).Conclusion In patients with PCG, WDT induced significant IOP elevation 15 and 30 min after the test, which returned to pre-test values after 45 min.

Recent Caffeine Drinking Associates with Cognitive Function in the UK Biobank.

Clinical evidence points to the premise that caffeine may benefit cognition, but whether these findings extend to real life settings and amidst factors that impact caffeine metabolism is unclear. The aim of this study was to investigate the impact of recent caffeine drinking on cognitive ability while additionally accounting for lifestyle and genetic factors that impact caffeine metabolism. We included up to 434,900 UK Biobank participants aged 37–73 years, recruited in 2006–2010, who provided biological samples and completed touchscreen questionnaires regarding sociodemographic factors, medical history, lifestyle, and diet. Recent caffeine drinking (yes/no in the last hour) was recorded during a physical assessment. Participants completed at least one of four self-administered cognitive function tests using the touchscreen system: prospective memory (PM), pairs matching (Pairs), fluid intelligence (FI), and reaction time (RT). Multivariable regressions were used to examine the association between recent caffeine drinking and cognition test scores. We also tested interactions between recent caffeine drinking and a genetic caffeine-metabolism score (CMS) on cognitive function. Among white participants, recent caffeine drinking was associated with higher performance on RT but lower performance on FI, Pairs, and PM (p ≤ 0.004). Similar directions of associations for FI (p = 0.09), Pairs (p = 0.03), and PM (p = 0.34) were observed among non-white participants. No significant and consistent effect modification by age, sex, smoking, test time, habitual caffeine intake, or CMS was observed. Caffeine consumed shortly before tasks requiring shorter reaction times may improve task performance. Potential impairments in memory and reasoning tasks with recent caffeine drinking warrant further study.

Galactose Ingested with a High-Fat Beverage Increases Postprandial Lipemia Compared with Glucose but Not Fructose Ingestion in Healthy Men

ABSTRACTBackgroundFructose ingestion with a high-fat beverage increases postprandial lipemia when compared with glucose. It is unknown whether other sugars, such as galactose, also increase postprandial lipemia.ObjectivesThe objective was to assess whether galactose ingestion within a high-fat beverage increases postprandial lipemia relative to glucose or fructose.MethodsTwo experiments were conducted, which contrasted different test drinks under otherwise standardized conditions. In Experiment 1, 10 nonobese men (age: 22 ± 1 y; BMI, 23.5 ± 2.2 kg/2) ingested either galactose or glucose (0.75 g supplemented carbohydrate per⋅kilogram body mass) within a high-fat test drink (0.94 g fat per kilogram body mass). In Experiment 2, a separate group of 9 nonobese men (age: 26 ± 6 y; BMI: 23.5 ± 2.6 kg/m2) ingested either galactose or fructose (identical doses as those in Experiment 1) within the same high-fat test drink. Capillary blood was sampled before and at frequent intervals after ingestion of the test drinks for a 300-min period to determine plasma triacylglycerol, glucose, lactate, nonesterified fatty acid, and insulin concentrations. Paired t tests and 2-way, repeated-measures ANOVA were used to compare conditions within each experiment.ResultsThe incremental AUC for triacylglycerol was greater following galactose ingestion compared with glucose (127 ± 59 compared with 80 ± 48 mmol⋅L−1 × 300 min, respectively; P = 0.04) but not compared with fructose (136 ± 74 compared with 133 ± 63 mmol⋅L−1 ×300 min, respectively; P = 0.91). Plasma lactate concentrations also increased to a greater extent with galactose compared with glucose ingestion (time–condition interaction: P < 0.001) but not fructose ingestion (time–condition interaction: P = 0.17).ConclusionsGalactose ingestion within a high-fat beverage exacerbates postprandial lipemia and plasma lactate concentrations compared with glucose but not fructose in nonobese men. These data suggest that galactose metabolism may be more similar to fructose than to glucose, providing a rationale to reassess the metabolic fate of galactose ingestion in humans. This trial was registered at clinicaltrials.gov as NCT03439878.

Pre-exercise Trehalose Ingestion Enhanced Exercise Performance in Male Collegiate Distance Runners

A total of 10 male collegiate distance runners participated in a randomized crossover trial. After completing a warm-up, each participant ingested 300 mL of a test drink and performed 2 sets of pedaling for the duration of 10 minutes (tests 1 and 3) and a 30-second sprint test (tests 2 and 4) with 3-minute interval. During the exercise tests, participants were instructed to make a full power output in 30-second sprint tests and to keep the effort equivalent to their own pace in 10 000 m track race without a final push in the 10-minute pedaling phase. The test drinks allocated to the participants were either trehalose (6% w/v), glucose (6% w/v), or water. During the 4 tests, trehalose presented with the highest mean power outputs compared to that of glucose and water. It was statistically significant against water and glucose especially in the first 10 minutes of pedaling (test 1) and the last 30 seconds of sprint tests (test 4). Therefore, data indicate that trehalose may enhance exercise performance.

COFFEE VOLUME DOES NOT SUPPRESS APPETITE OR CHANGE PERCEIVED HUNGER IN HABITUAL CAFFEINE CONSUMERS

Caffeine is a heavily consumed substance that has several benefits, including appetite suppression and increased energy metabolism. PURPOSE: To determine the effect of caffeine amount and coffee volume on appetite profile, affective response, cognitive function, blood glucose levels and subsequent energy intake in female habitual caffeine consumers. METHODS: 19 healthy female (age: 24 ± 8, BF%: 24.9 ± 5.1) habitual caffeine consumers (255 ± 122 mg/day) ingested coffee of different volumes and caffeine amounts on four different occasions (C1: 237 ml/4 mg/kg; C2: 237 ml/6mg/kg; C3: 473 ml/4mg/kg; C4: 473 ml/6mg/kg) in a single blind, randomized, crossover design. Participants completed a visual analog scale (VAS) of appetite profile at pre, 0, 30 and 60 minutes. Affective response and cognitive function were assessed using the Activation-Deactivation Adjective Checklist (AD-ACL), Trail Making (TM) and Stroop tasks (ST) before and after the test drink. Blood glucose levels were measured at pre, 30 and 60 minutes. In addition, ad libitum breakfast was consumed at 60 minutes and 24-hour self-reported energy intake was recorded. A repeated measures ANOVA was used for analysis with significance accepted at p<0.05. RESULTS: A significant time (p<0.001), but not condition effect was observed in hunger (p=0.31), satiety (p=0.16), fullness (p=0.11), desire to eat (p=0.31) and prospective food consumption (p=0.19). No significant condition effect was observed in blood glucose levels (p=0.12), energy intake at breakfast (C1: 440 ± 213; C2: 400 ± 158; C3: 440 ± 226; C4: 386 ± 138 calories, p=0.43) or over 24-hours (C1: 16773 ± 532; C2: 1486 ± 434; C3: 1503 ± 321; C4: 1662 ± 505 calories, p=0.28). However, a significant interaction effect was observed in tiredness, calmness, energy and tension (p=0.02). In addition, a significant time (p<0.001) but not condition effect (p>0.05) was observed in TM, ST and state anxiety. Participants’ time to complete cognitive tasks decreased and state anxiety increased over time. CONCLUSIONS: Coffee volume may not have an effect on appetite suppression and perceived hunger, however, may modulate affective responses.

Evaluation of Intraocular Pressure After Water Drinking Test in Patients with Unilateral Hemifacial Spasm.

PurposeThe aim of the study is to examine the baseline intraocular pressure (IOP) and its changes after performing a water drinking test (WDT) in patients with unilateral hemifacial spasm (HFS).Patients and MethodsIn this prospective observational study, patients aged 21 years and above diagnosed with unilateral HFS were recruited from the Singapore National Eye Centre between January 2015 and August 2016. The unaffected eye of each patient served as a matched control. An interviewer-administered standardized questionnaire on HFS symptoms and ophthalmic examination was performed. Automated perimetry, optical coherence tomography (OCT) of the optic nerve head, color disc stereophotography and water drinking test (WDT) were done. The primary outcome measure was the difference in IOP between eyes affected by HFS and fellow eyes at baseline and at 15, 30 and 45 minutes of the WDT.ResultsFifty-four patients with unilateral HFS were included. Mean age was 59.8±9.9 years (range, 37.0–84.0). Of these, 54% were female and 94% were Chinese. Mean baseline IOP was significantly higher in eyes with HFS (13.9±3.1mmHg) compared to fellow eyes (13.3±2.8mmHg) (p=0.008). There was no significant difference in absolute or percentage change in IOP from baseline between the 2 groups at 15, 30 and 45 minutes of the WDT. Mean vertical cup–disc ratio (VCDR) on clinical examination was significantly higher in eyes with HFS (0.5±0.2) compared to fellow eyes (0.4±0.2) (p=0.02). There was no significant difference between the groups for visual field parameters and mean retinal nerve fiber layer thickness on OCT.ConclusionHemifacial spasm is associated with a small but significant difference in mean baseline IOP and VCDR between affected and fellow eyes. However, when eyes affected by HFS and fellow eyes were challenged with the WDT, both responded in similar ways.

Preservation of Lean Mass upon Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes During 6-Months Follow-Up After RCT (PROBE Study)

Abstract Objectives Weight loss is a key element in the treatment of obesity and type 2 diabetes (T2D), but also a risk factor for lean mass (LM) loss in older adults. We evaluated whether a whey protein drink enriched with leucine and vitamin D preserved LM during 3-month lifestyle intervention and whether effects sustained during 6 months follow-up after intervention (FU). Methods 123 older adults (66 ± 6 y) with obesity (BMI 34 ± 4 kg/m2) and T2D participated in a 3-month lifestyle intervention with dietary advice (−600 kcal/d) and resistance exercise (3×/wk). In this double-blind RCT (PROBE) subjects were randomised to receive 10×/wk a test (21 g protein) or isocaloric control (0 g protein) drink. LM, appendicular muscle mass (AMM), leg muscle mass (LMM), and fat mass (FM) were assessed with DXA. Mixed linear model analysis was used with baseline value in the outcome vector and adjustment for stratification factors sex and SU-derivate use. Data represent EMM ± SE (within group) or 95% CI (between groups). Results 105 subjects completed intervention and 76 subjects participated in FU. At 3 months, body weight (−2.2 ± 0.4 kg, P &amp;lt; 0.001, test; −2.9 ± 0.4 kg, P &amp;lt; 0.001, control) and FM (−2.6 ± 0.4 kg, P &amp;lt; 0.001, test; −2.5 ± 0.4 kg, P &amp;lt; 0.001, control) were reduced without differences between groups. LM and AMM were increased in test (+0.57 ± 0.27 kg, P = 0.03; +0.39 ± 0.13 kg, P &amp;lt; 0.01) and unchanged in control (−0.35 ± 0.26 kg, P = 0.18; +0.03 ± 0.12 kg, P = 0.80), with significant difference between groups (+0.92 kg, 95% CI 0.19–1.65, P = 0.015; +0.36 kg, 95% CI 0.01–0.71, P = 0.047). At FU (without test or control drink), the difference in LM and AMM between groups had disappeared while both groups still had significantly improved body composition compared to baseline, as reflected by decreased FM (−2.4 ± 0.4 kg, &amp;lt; 0.001, test; −2.6 ± 0.4 kg, &amp;lt; 0.001, control) and increased or preserved LM (+0.88 ± 0.32 kg, 0.007; +0.54 ± 0.32 kg, 0.09) and AMM (+0.46 ± 0.15 kg, 0.002; +0.31 ± 0.15 kg, 0.03). Conclusions Use of a whey protein drink enriched with leucine and vitamin D during a combined lifestyle intervention showed beneficial effects on lean mass in older adults with obesity and type 2 diabetes. Preservation of lean mass was sustained after 6 months follow-up, without differences between treatment groups. Funding Sources Grant: Topsector Agri &amp; Food, The Netherlands. Financial support for study conduct: Danone Nutricia Research.

Consuming decaffeinated coffee with milk and sugar added before a high-glycaemic index meal improves postprandial glycaemic and insulinaemic responses in healthy adults.

The present study aimed to compare the effects of drinking different types of coffee before a high-glycaemic index (GI) meal on postprandial glucose metabolism and to assess the effects of adding milk and sugar into coffee. In this randomised, crossover, acute feeding study, apparently healthy adults (n 21) consumed the test drink followed by a high-GI meal in each session. Different types of coffee (espresso, instant, boiled and decaffeinated, all with milk and sugar) and plain water were tested in separate sessions, while a subset of the participants (n 10) completed extra sessions using black coffees. Postprandial levels of glucose, insulin, active glucagon-like peptide 1 (GLP-1) and nitrotyrosine between different test drinks were compared using linear mixed models. Results showed that only preloading decaffeinated coffee with milk and sugar led to significantly lower glucose incremental AUC (iAUC; 14 % lower, P = 0·001) than water. Preloading black coffees led to greater postprandial glucose iAUC than preloading coffees with milk and sugar added (12-35 % smaller, P < 0·05 for all coffee types). Active GLP-1 and nitrotyrosine levels were not significantly different between test drinks. To conclude, preloading decaffeinated coffee with milk and sugar led to a blunted postprandial glycaemic response after a subsequent high-GI meal, while adding milk and sugar into coffee could mitigate the impairment effect of black coffee towards postprandial glucose responses. These findings may partly explain the positive effects of coffee consumption on glucose metabolism.