Increased Fiber Intake Research Articles

Modifications in the Consumption of Energy, Sugar, and Saturated Fat among the Mexican Adult Population: Simulation of the Effect When Replacing Processed Foods that Comply with a Front of Package Labeling System.

A Mexican Committee of Nutrition Experts (MCNE) from the National Institute of Public Health (INSP), free from conflict of interest, established food content standards to place the front-of-package (FOP) logo on foods that meet these nutrition criteria. The objectives were to simulate the effect on nutrient intake in the Mexican adult population (20–59 years old) after replacing commonly consumed processed foods with those that meet the FOP nutrition-labeling criteria. Twenty-four hour dietary recalls were collected from the 2012 Mexican National Health and Nutrition Survey (n = 2164 adults). A food database from the INSP was used. Weighted medians and 25–75 inter-quartile ranges (IQR) of energy and nutrient intake were calculated for all subjects by sociodemographic characteristics before and after replacing foods. Significant decreases were observed in energy (−5.4%), saturated fatty acids (−18.9%), trans-fatty acids (−20%), total sugar (−36.8%) and sodium (−10.7%) intake and a significant increase in fiber intake (+15.5%) after replacing foods, using the MCNE nutrition criteria. Replacing commonly consumed processed foods in the diet with foods that meet the FOP nutrition-labeling criteria set by the MCNE can lead to improvements in energy and nutrient intake in the Mexican adult population.

Plant-Based Lunch at Work: Effects on Nutrient Intake, Environmental Impact and Tastiness—A Case Study

The aim of this study was to determine the environmental impact, nutrient intake, appreciation and tastiness of three buffet-style lunches served at the workplace, consisting of (1) animal-based foods; (2) plant-based foods; and (3) both animal-based and plant-based foods. Employees of the National Institute for Public Health and the Environment in the Netherlands participated in the study. Participants scored the lunch for appreciation and tastiness (scores from 1 to 10). Greenhouse gas (GHG) emissions and land use associated with foods consumed were calculated using life cycle assessments. Nutrient intake was calculated using food composition data. The results show that both the plant-based and the combination lunch received higher scores for tastiness than the animal-based lunch. GHG emissions and land use were lowest for the plant-based lunch and highest for the animal-based lunch. The combination lunch was associated with increased fiber and decreased saturated fat intake compared to the animal-based lunch, but also lead to increased energy intake. The plant-based lunch did not increase energy intake, while increasing fiber intake and decreasing sodium (salt) and saturated fat intakes. These initial results show that plant-based lunches have the potential to improve nutrient intake and tastiness while reducing environmental impact. Additional research in this field is worthwhile.

Use acid-suppressing drugs appropriately with an individualized approach to minimize the risk of infection

Acid-suppressing drugs (ASDs) have been associated with an increased risk of various infections, although causality has not been determined owing to data limitations and conflictions. As such, ASDs should be used cautiously and be limited to appropriate evidence-based settings. ASD regimens should also be individualized (taking into account patient risk factors, likelihood of adverse events and drug interactions) and the overall risks and benefits of the therapy balanced. It may also be prudent to consider adjunctive preventative measures, such as prebiotics, probiotics, increased fibre intake and correction of vitamin D status.

Does Perception of Dietary Fiber Mediate the Impact of Nutrition Knowledge on Eating Fiber-Rich Bread?

The average daily intake of fiber is still too low in relation to nutritional recommendations, as was found in several studies. Therefore, it is necessary to recommend ways to increase fiber intake in the diet. Increasing the consumption of bread rich in fiber as a substitute of white bread is one of the ways to increase fiber intake. The aim of this study was to find out whether nutrition knowledge and perception of dietary fiber affected the frequency of eating wholemeal bread and white bread fortified with fiber. The data were collected in 2014 through a cross-sectional quantitative survey that was performed under the Bioproduct project among a group of 1013 Polish adults. The associations between variables were investigated using multiple regression analysis. The respondents’ general knowledge on nutrition influenced their knowledge on fiber intake (correlation coefficient r = 0.30). Respondents with a greater knowledge perceived higher benefits of consuming cereal products that were fortified with fiber (r = 0.78), and attached greater importance to the information on the label (r = 0.39) as well. The nutrition knowledge determined the familiarity with fiber-enriched bread and the consumption of this product (r = 0.40) to a greater degree than the frequency of wholemeal bread consumption (r = −0.10). The respondents’ perception of dietary fiber was observed to play a partial mediation role between the knowledge on nutrition and the consumption of both kinds of breads, suggesting that it can be an important predictor of bread consumption. To increase the consumption of bread that is rich in fiber, emphasis should be laid on specific information on fiber, referring to food products as well as on individual’s perception of those products. The said information should be reinforced along with overall communication regarding nutrition to influence the bread-related decisions.

Dried fruit and dental health – how strong is the evidence?

AbstractChildren's dental health in England has shown improvement in recent decades. However, 24.7% of 5 year‐olds have obvious decay, with the average number of affected teeth being 3.4, and tooth decay is the most common reason for hospital admissions in 5–9 year‐olds. Public Health England advises that foods and drinks containing free sugars are limited because of the increased risk of dental caries associated with frequent intakes. Although dried fruit contains more sugars than fresh fruit by weight due to the dehydration process, the portion size of dried fruit is 30 g compared with 80 g for fresh fruit. Additionally, these sugars are not defined as ‘free’ according to the current UK definition. However, unlike other sources of natural sugars, dried fruit is recommended to be eaten with meals only rather than as a snack because there is a supposition that it ‘sticks’ to teeth. A comprehensive review of the evidence published last year found a lack of good quality studies to support this advice. In the absence of data from intervention and cohort studies for effects of dried fruit on dental caries endpoints, studies of proxy measures of tooth demineralisation show inconsistent effects on plaque pH and acidogenicity. Measurement of net demineralisation, following consumption of raisins seven times a day for 10 days, showed comparable effects with fresh fruit and vegetables under similar conditions. Oral retention (‘sticking’) has been investigated in few subjects. The results do not demonstrate that dried fruit is worse in terms of oral clearance than alternative snack foods. More robust research with validated methods is needed before firm conclusions can be drawn about the retention of dried fruit, and hence its potential for adverse effects on teeth. This is important because eating traditional dried fruits can help towards the achievement of a number of dietary recommendations, including contributing to the 5 A DAY target and increasing fibre intake.

Orange sweet potato (Ipomoea batatas) puree improved physicochemical properties and sensory acceptance of brownies

Abstract Daily fibre consumption among consumers is less than the recommended amount. Hence, fibre enrichment in desserts is proposed to increase fibre intake. The objective of the research was to study the effect of orange sweet potato (OSP) puree at different levels (0%, 25%, 50% and 75%) on physicochemical and sensory acceptance of brownies. Substitution of wheat flour with OSP puree in brownies formulations significantly increased total dietary fibre in the order: 75% OSP (6.41%) > 50% OSP (5.13%) > 25% OSP (3.24%) > 0% (1.70%). Additionally, moisture, fat, and specific volume were elevated with increased amount of OSP puree. Colour of brownies was affected with decrease of lightness (L∗), redness (a∗) and most prominently in yellowness (b∗). Hardness, adhesiveness, gumminess, cohesiveness and chewiness of brownies reduced significantly with incorporation of up to 50% OSP puree, but 75% OSP puree brownies was insignificant with 50% OSP puree brownies. Springiness and resilience had more prominent impact with increased amount of OSP puree. Sensory scores of appearance and colour of enriched fibre did not differ significantly with control brownies. However, texture, flavour and overall acceptability of the brownies were most preferred for 50% and 75% OSP puree substitution. The study suggests that OSP substitution at 50% and 75% are suitable to increase fibre in brownies with little effects on the appearance and were able to improve sensory attributes.

Supporting patients in reducing postoperative constipation: fundamental nursing care - a quasi-experimental study.

The prevalence of constipation in the general population is 2-28%. Patients with constipation report symptoms of abdominal pain, bloating, nausea, straining to defecate and general discomfort. Strategies for preventing constipation include laxatives, exercise and increased fluid and fibre intake, but life style adjustments, such as exercise, eating more fibres and drinking more fluids, were not considered a solution by older patients. Previous studies have shown that actively involving patients through individualised care and support increases patients' outcome. To test the efficacy of a nursing intervention based on active patient involvement including individualised nursing care plans and daily dialogues for patients with hip fractures in preventing constipation after surgery. A quasi-experimental design was applied. Inclusion criteria hip fracture needing surgery, understand Danish. Exclusion criteria dementia, gastrointestinal disease. A total of 186 patients were included and 155 completed. An admission interview including Constipation Risk Assessment Scale was undertaken. On that basis an individualised nursing care plan was made. At admission, discharge and 30 days after surgery constipation, intake of fibres and fluid were measured. The Bristol Stool Scale and Rasmussen's scale were used to measure constipation. Patients in the control group received standard care of the ward. After 30 days constipation rates for patients in the intervention group were significantly lower than for patients in the control group (p = 0.042). The fibre intakes and fluid intakes were significantly higher in the intervention group (p ≤ 0.001). The effect of liquid intake was statistically significant (OR = 1.1, 95% CI: 1.0-1.2). Likewise, the effect of fibre intake was statistically significant; the odds of constipation decreased with increasing fibre intake (OR = 0.4, 95% CI: 0.2-0.8). Patients with hip fractures that were actively involved in their own care in preventing constipation were significantly less constipated 30 days after surgery than control patients. Increases in fluid and fibre intakes had significant effects on reducing the risk of developing constipation.

Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome-Substudy of randomized trial between diet, exercise and diet plus exercise for weight control.

Polycystic ovary syndrome (PCOS) is commonly affected by obesity. PCOS phenotypes are prone to increased waist/hip ratio, insulin resistance and dyslipidaemia. This substudy was undertaken to evaluate the effects of lifestyle interventions on metabolic biomarkers in overweight/obese PCOS women and the interventional effects of dietary components related to metabolic outcomes. Randomized three-arm parallel study. Fifty-seven PCOS women body mass index (BMI >27kg/m2 , age 18-40) were randomly assigned to diet (D, n=19), exercise (E, n=19) or diet plus exercise (DE, n=19) in three-arm fashion over 16weeks. The D group received nutritional counselling by a dietician to reduce their energy intake by at least 600kcal/d. The E group received an ambulatory exercise regimen from a physiotherapist. The DE group had both interventions. Self-reported food intake over 4days, exercise pedometers, BMI, waist/hip ratio, blood pressure, body composition and oral glucose tolerance test were performed before and at the end of intervention. BMI, waist circumference and total cholesterol were significantly reduced in the D and DE groups, as well as low-density lipoprotein and Homeostasis Model of Assessment index in the D group. In the E group, exercise was increased along with a decrease in BMI and waist circumference. The strongest predictor of reduced BMI was increased fibre intake (-0.44, P=.03), while a decrease in trans fatty acid intake predicted reduced insulinogenic index (0.44, P<.01). Nutritional counselling with dieting is clearly effective to improve metabolic disturbances in overweight/obese women with PCOS. Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement and weight control.

Glycemic index, glycemic load and carbohydrate intake in association with risk of renal cell carcinoma.

Carbohydrate intake affects postprandial glucose levels and insulin response, which plays a role in carcinogenesis. The relationship between carbohydrate intake, dietary glycemic index (GI) and glycemic load (GL), and risk of renal cell carcinoma (RCC) remains unclear. We conducted a case-control study including 854 patients with newly diagnosed RCC (cases) and 1255 healthy participants (controls) recruited since 2002. GI, GL and carbohydrate intake were obtained via a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression, adjusting for potential confounders. We found that higher GI was significantly associated with RCC risk with an OR of 1.32 (95% CI, 0.99-1.74; Ptrend = 0.026) (the highest versus the lowest quartiles). We also observed an inverse association between fiber intake and RCC risk with OR of 0.70 (95% CI = 0.50-0.99) as well as between starch intake and risk of RCC with OR of 0.65 (95% CI = 0.49-0.87). Individuals with a high-GI diet and hypertension or high body mass index (BMI) had a 2.7 times (OR = 2.67, 95% CI = 1.96-3.64) and two times (OR = 1.95, 95% CI = 1.29-2.92) higher RCC risk, respectively, than those without these factors. Our findings suggest that a high-GI diet is associated with an increased risk of RCC, whereas increased fiber and starch intakes appear to be associated with a decreased risk of RCC. We found that reducing GI levels and increasing fiber intake could be a dietary strategy to decrease RCC risk, especially for individuals with hypertension or high BMI.

Assessing beans as a source of intrinsic fiber on satiety in men and women with metabolic syndrome

Dietary fiber is well-known for its satiety inducing properties. Adding fibers to mixed dishes is one way to increase fiber intake. However, adding fibers to foods versus including foods inherently containing fiber may reveal differing effects on satiety. The present study aimed to explore the satiety effects of adding fiber to a mixed meal versus using beans (Phaseolus vulgaris) as a source of intrinsic fiber in the meal. In this pilot study, 12 men and women with metabolic syndrome were randomly assigned to eat three standard meals in a crossover design on three different occasions that contained either no added fiber (control (NF)), extrinsic or added fiber (AF), or whole black beans as the source of intrinsic fiber (BN). Meals were matched for energy and macronutrient composition. Five hour postprandial subjective satiety was measured along with blood glucose, insulin, and the GI hormones, cholecystokinin (CCK) and peptide tyrosine tyrosine (PYY3-36). All meals induced fullness to a similar degree; however, the AF meal suppressed prospective consumption (F2,187 = 9.05, P = 0.0002) compared to the BN or NF meals. The NF meal tended to result in more satisfaction than the BN meal (F2,187 = 5.91, P = 0.003). The BN meal produced significantly higher postprandial CCK concentrations compared to the AF (F2,187 = 6.82, P = 0.001) and NF meals (F2,187 = 6.82, P = 0.002). Similar findings were observed for PYY3-36 response for BN > AF meal (F2,170 = 9.11, P < 0.0001). Postprandial insulin was significantly reduced after the BN meal, compared to the NF (F2,187 = 22.36, P < 0.0001) meal. These findings suggest that incorporating whole black beans into a meal has acute beneficial metabolic and GI hormone responses in adults with metabolic syndrome and are preferred over adding equivalent amounts of fiber from a supplement.

Impact of Agaricus bisporus mushroom consumption on satiety and food intake

Previous studies on mushrooms suggest that they can be more satiating than meat, but this effect has not been studied with protein-matched amounts. The objective of this study was to assess the differences with satiety and ten-day food intake between A. bisporus mushrooms (226 g) and meat (28 g) in a randomized open-label crossover study. Thirty-two healthy participants (17 women, 15 men) consumed two servings of mushrooms or meat for ten days. On the first day, fasted participants consumed protein-matched breakfasts. Participants rated their satiety using visual analogue scales (VAS) at baseline and at regular intervals after the meal. Three hours later, participants were served an ad libitum lunch. Participants were given mushrooms or meat to consume at home for the following nine days. Energy intake was assessed at the ad libitum lunch, and participants also completed diet diaries on the day of the study, day 2, and day 10. Participants reported less hunger (p = 0.045), greater fullness (p = 0.05), and decreased prospective consumption (p = 0.03) after the mushroom breakfast. There were no significant differences in participant ratings of satisfaction (p = 0.10). There were also no statistically significant differences in energy intake at the ad libitum lunch or with the diet diaries from days 1 (p = 0.61), 2 (p = 0.77), or 10 (p = 0.69). Mushroom consumption did increase fiber intake on days 1, 2, and 10 but the difference in fiber consumption was only statistically significant on day 2 (p = 0.0001). The mushroom intervention also did not affect energy intake over the ten day feeding period.

Dietary fiber intake is associated with chronic kidney disease (CKD) progression and cardiovascular risk, but not protein nutritional status, in adults with CKD.

Evidence suggests that dietary fiber benefits patients with chronic kidney disease (CKD); however, this conclusion requires further validation. In this study, we examined the effects of dietary fiber on kidney function, inflammation, indoxyl sulfate, nutritional status, and cardiovascular risk in patients with advanced CKD. We performed linear regressions to assess the association between dietary fiber intake and CKD parameters. The aforementioned parameters were compared over an 18-month follow- up period. Kaplan-Meier analysis was used to investigate the association between fiber intake and Cardiac vascular disease (CVD). In total, 157 patients were included in this study. Dietary fiber and inflammatory indices were associated (interleukin [IL]-6: β=-0.024, p=0.035). The differential estimated glomerular filtration rate (ΔeGFR) as well as levels of C-reactive protein, IL-6, indoxyl sulfate, and serum cholesterol in the higher fiber intake (>=25 g/day) group were lower than those in the lower fiber intake (<25 g/day) group (p<0.05). Differences in IL-6 and indoxyl sulfate levels were more significant in patients in the higher protein intake group (p<0.05). Dietary fiber intake may be a protective factor associated with CVD (hazard ratio=0.537 and 0.305- 0.947). The protein nutritional status was not different between the two groups (p>0.05). Our results suggest that increasing fiber intake can retard the decrease in the eGFR; can reduce the levels of proinflammatory factors, indoxyl sulfate, and serum cholesterol; and is negatively associated with cardiovascular risk, but does not disrupt the nutritional status of patients with CKD.

Managing Gestational Weight Gain: Obstetricians' Perceived Barriers and Interventions.

To support optimal health outcomes during pregnancy, understanding obstetricians' (OBs) recommendations for and barriers to managing gestational weight gain (GWG) can benefit childbirth educators. This mailed survey examined OBs' practices (n = 63) for managing GWG along with perceived barriers. The most frequent recommendations were (a) increase activity (76.2%), (b) aerobic activity (63.5%), (c) patient education about weight management (61.9%), (d) increase fiber intake (61.3%), and (e) use of guidelines for weight gain (58.7%). Self-tracking weight gain charts were the least used. Greatest barriers to GWG management were (a) patients not interested in changing behavior (77.8%), (b) high relapse rates (66.7%), (c) lack of community resources (60.3%), (d) patients cannot afford referrals (58.7%), and (e) lack of time (53.9%).

Impacto da intervenção multiprofissional em grupo no perfil nutricional e hábitos de vida de mulheres com sobrepeso e obesidade

Este estudo teve como objetivo analisar o impacto da intervenção multiprofissional em grupo no tratamento de mulheres com excesso de peso. Foi realizado estudo de intervenção não controlado de caráter quantitativo com mulheres que apresentavam sobrepe so ou obesidade, submetidas a um grupo coordenado por equipe multiprofissional que associou o aconselhamento nutricional, o exercício físico e ações da psicologia voltadas para a motivação e mudança comportamental por um período de 12 semanas. Foram realizadas avaliações antropométricas e dietéticas mediante Questionário de Frequência Alimentar antes e após a intervenção, além de um questionário relacionado às mudanças alcançadas e a satisfação com o grupo. Para a análise estatística foi utilizado o teste t de Student, considerando o nível de significância menor que 5%. Após a intervenção houve redução significativa (p&lt;0,001) do peso, circunferência da cintura e Índice de Massa Corporal. Foram observadas também mudanças importantes nos hábitos de vida como o aumento do nível de atividade física, aumento do consumo de fibras e a redução do sal, alimentos industrializados, açúcares e frequência do consumo de carnes vermelhas. Em relação à adesão, 55% dos participantes não finalizaram o programa, como justificativa da não adesão a falta de tempo foi a razão mais citada pelos desistentes. Conclui-se que a intervenção multiprofissional em grupo constitui uma importante estratégia no tratamento do sobrepeso e obesidade, pois consegue trabalhar os diferentes aspectos que envolvem o excesso de peso, contribuindo para a mudança de hábitos de vida e redução dos fatores de riscos associados.

Pengaruh intervensi pendidikan gizi terhadap peningkatan pengetahuan gizi, perubahan asupan zat gizi dan indeks massa tubuh remaja kelebihan berat badan

Background: Adolescence overweight due to excessive intake and physical inactivity. This situation will continue until adulthood and cause degenerative diseases. The prevalence of overweight adolescents in senior high school Pontianak is 16,8% (higher than prevalence of obese adolescents in Indonesia).Objective: Analyze impact of nutrition education intervention to increase nutritional knowledge, change nutrient intake and Body Mass Index (BMI) among adolescent overweight in Pontianak high school.Methods: Quasi-experimental study design with control group pre-post test design. Nutrition education intervention to treatment group was gave once a week for 3 months and control group was gave only one for 3 months study. The subject are 73 overweight high school students, taken by purposive sampling and divided into 2 groups: 36 treatment group and 37 control group. Statistical analysis using paired t-test, Wilcoxon test, Independent t-test, Mann-Whitney Test and covariance.Results: This result shows that nutrition education intervention increase nutrition knowledge score (9.58±11.82) and fiber intake (1.05±5.29 g) in treatment group; reduce energy sufficiency rate in treatment and control group (12.42±16.77% and 10.18±0.54%); reduce protein adequacy rate (7.61±12.05%%), carbohydrate intake (3.78±6.71%) and reduce fat intake (3.11±3.96%) in treatment group; reduce BMI in treatment and control group (0.58±0.67 kg/m2 and 0.12±0.34 kg/m2).Conclusion: Nutrition education in overweight adolescent can decrease BMI among them through increase their nutrition knowledge. Nutrition knowledge of overweight adolescent decrease energy adequacy level, protein adequacy level, carbohydrate intake percentage, fat intake percentage, and increase fiber intake.

Dietary Fiber Intake Is Inversely Associated with Periodontal Disease among US Adults

Background: Approximately 47% of adults in the United States have periodontal disease. Dietary guidelines recommend a diet providing adequate fiber. Healthier dietary habits, particularly an increased fiber intake, may contribute to periodontal disease prevention.Objective: Our objective was to evaluate the relation of dietary fiber intake and its sources with periodontal disease in the US adult population (≥30 y of age).Methods: Data from 6052 adults participating in NHANES 2009–2012 were used. Periodontal disease was defined (according to the CDC/American Academy of Periodontology) as severe, moderate, mild, and none. Intake was assessed by 24-h dietary recalls. The relation between periodontal disease and dietary fiber, whole-grain, and fruit and vegetable intakes were evaluated by using multivariate models, adjusting for sociodemographic characteristics and dentition status.Results: In the multivariate logistic model, the lowest quartile of dietary fiber was associated with moderate-severe periodontitis (compared with mild-none) compared with the highest dietary fiber intake quartile (OR: 1.30; 95% CI: 1.00, 1.69). In the multivariate multinomial logistic model, intake in the lowest quartile of dietary fiber was associated with higher severity of periodontitis than dietary fiber intake in the highest quartile (OR: 1.27; 95% CI: 1.00, 1.62). In the adjusted logistic model, whole-grain intake was not associated with moderate-severe periodontitis. However, in the adjusted multinomial logistic model, adults consuming whole grains in the lowest quartile were more likely to have more severe periodontal disease than were adults consuming whole grains in the highest quartile (OR: 1.32; 95% CI: 1.08, 1.62). In fully adjusted logistic and multinomial logistic models, fruit and vegetable intake was not significantly associated with periodontitis.Conclusions: We found an inverse relation between dietary fiber intake and periodontal disease among US adults ≥30 y old. Periodontal disease was associated with low whole-grain intake but not with low fruit and vegetable intake.

Effects of aerobic exercise and diet intervention on glycaemic control and liver fat content in men and women aged 50–65 years with prediabetes and non-alcoholic fatty liver disease: a multicentre, randomised controlled trial

BackgroundPrediabetes and non-alcoholic fatty liver disease precede development of type 2 diabetes; however, appropriate lifestyle interventions might help to prevent such progression. We aimed to test whether aerobic exercise training and a high-fibre diet can reduce hepatic fat content and increase insulin sensitivity in individuals with prediabetes and non-alcoholic fatty liver disease. MethodsWe did a randomised controlled trial in seven clinics in Yangpu district, Shanghai, China. We recruited individuals aged 50–65 years with impaired fasting glucose (5·6–6·9 mmol/L) or impaired glucose tolerance (2 h glucose 7·8–11·0 mmol/L) and diagnosed non-alcoholic fatty liver disease. We randomly assigned (1:1:1:1) participants to receive aerobic exercise, diet intervention, aerobic exercise plus diet intervention, or no intervention (control group) for 8 months. A computer program was used to generate the block randomisation sequence (block size 20). Progressive aerobic exercise training (60–75% intensity) was given three to five times per week in 30–60 min sessions. The diet intervention aimed to include 40% carbohydrate with a fibre intake of 18–25 g per day. The primary outcomes were hepatic fat content (assessed by proton magnetic resonance spectroscopy [1H MRS]) and insulin sensitivity (assessed by oral glucose tolerance test), analysed in the intention-to-treat population. We also examined participants' DNA samples for PNPLA3 genotypes. Ethics approval was granted by the Ethics Committee of Shanghai Institute of Nutrition (ref 2013-003), and all participants provided written informed consent. This trial is registered with the ISRCTN registry, number ISRCTN42622771. FindingsBetween June 1 and Dec 25, 2013, we screened 603 individuals, of whom 115 were eligible and randomly assigned to the exercise group (n=29), diet group (n=28), exercise plus diet group (n=29), or control group (n=29). Mean change in hepatic fat content was −24·4% (95% CI −41·7 to 7·1) in the exercise group, −23·2% (−45·1 to −1·3) in the diet group, and −47·9% (−65·8 to −30·0) in the exercise plus diet group, and 20·9% (−4·4 to 46·2) in the control group (p=0·006, p=0·002, and p<0·0001, respectively, for all intervention groups compared with the control group). Among individuals who completed the intervention, hepatic fat content decreased to normal levels (<5·6%) in ten (44%) of 23 participants in the exercise plus diet group, three (14%) of 22 participants in the exercise group, and nine (41%) of 22 participants in the diet group. However, insulin sensitivity increased significantly in the exercise plus diet group only (14%; p<0·05). No difference was found in PNPLA3 genotypes (GG, GC, and CC) among the groups. InterpretationAerobic exercise training combined with high-fibre intake can help to reduce liver fat content and increase insulin sensitivity more effectively than either exercise or increased fibre intake alone in patients with prediabetes and non-alcoholic fatty liver disease. This combined intervention should be used to improve health in these patients. Moreover, identification of patients with high hepatic fat content with novel imaging techniques (such as 1H MRS) has the potential to maximise patient benefit and minimise intervention costs. FundingChina State Sport General Administration (2013B040 and 2015B039) and Chinese Nature Science Foundation (NSFC 31571219).

Resistant Starch Bagels Reduce Fasting and Postprandial Insulin in Adults at Risk of Type 2 Diabetes

Background: Type 2 diabetes (T2D) incidence continues to rise. Although increasing dietary fiber intake is an established strategy for improved glycemic control, most adults consume insufficient amounts. Fiber-enhanced functional foods can increase fiber intake, and there is particular interest in resistant starch (RS) as a high-fiber ingredient. Studies show that high-amylose maize resistant starch, type 2 (HAM-RS2) improves acute and chronic glycemic responses, but more studies are needed in individuals at high risk of T2D with RS delivered in commonly consumed foods.Objective: The objective of this study was to examine the chronic effects of consuming bagels high in HAM-RS2 on fasting and postprandial glycemic markers in adults at increased risk of T2D.Methods: With the use of a randomized, double-blind crossover design, 24 men and women with a mean ± SE age of 55.3 ± 1.59 y and body mass index (in kg/m2) of 30.2 ± 0.57 consumed 1 bagel containing 25 g HAM-RS2/d or 1 control wheat bagel/d for 56 d each, separated by a 4-wk washout. Fasting and postprandial oral-glucose-tolerance test (OGTT) glucose and insulin were measured on study days 1 and 57 of each bagel treatment.Results: The RS bagel treatment resulted in significantly lower fasting (22.1%, P = 0.04), 2-h (23.3%, P < 0.008), and 3-h (18.9%, P = 0.05) insulin incremental areas under the curve and fasting insulin resistance (homeostasis model assessment of insulin resistance; 23.1%, P = 0.04) than did the control bagel treatment. Fasting and postprandial OGTT glucose concentrations did not differ between the RS and control bagel treatments on study days 1 or 57.Conclusions: These data suggest that consumption of a high–HAM-RS2 bagel improves glycemic efficiency by reducing the amount of insulin required to manage postprandial glucose while improving fasting insulin sensitivity in adults at increased risk of T2D. This research provides support for a feasible dietary strategy for T2D risk reduction. This trial was registered at clinicaltrials.gov as NCT02129946.

De compras para la salud: Cereales de desayuno

It is no secret that breakfast is an important meal. Eating breakfast provides you with physical and mental energy to start the day, along with vitamins and minerals. Cereal is a quick, versatile, and budget-friendly breakfast choice. The benefits of eating a healthy cereal include increased fiber intake and lower body weight. But navigating the cereal aisle at your local grocery store can be an overwhelming experience. This 3-page fact sheet is the Spanish-language version of FSHN15-11/FS274: Shopping for Health: Breakfast Cereals. Written by Jenna Seckar and Wendy J. Dahl, and published by the Food Science and Human Nutrition Department, May 2016. FSHN15-11S/FS280: De compras para la salud: Cereales de desayuno (ufl.edu)

Association of Consumption of Different Pasta Food Categories with Diet Quality and Select Nutrient Intakes in Adults (19+ years) from NHANES, 2009–2012

Pasta represents a complex group of foods almost ubiquitously consumed in the American diet in both healthy and less healthy ways. The purpose of this analysis was to examine pasta consumption relative to overall diet quality [as measured by the Healthy Eating Index‐2010 (HEI)] as well as nutrients of public health concern (dietary fiber, calcium, potassium, and vitamin D) among adults using data from National Health and Nutrition Examination Survey (NHANES), 2009–2012 (n=10,697). USDA food categories were utilized to separate pasta consumers from non‐consumers from dietary data reported through a 24‐hour dietary recall: (a) 4004: Pasta, noodles and cooked grains (excluding non‐pasta grains) (PN); b) 3204: Pasta mixed dishes, excludes macaroni and cheese (PMD); and c) 3206: Macaroni and cheese (MC). Regression models employed the survey design features and sampling weights and were adjusted for relevant covariates (i.e., age, gender, race/ethnicity, poverty income ratio, physical activity level, current smoking status, alcohol, and energy intake, when appropriate); significance was set at p&lt;0.05. When pasta consumers as a group were compared to non‐consumers, no differences in overall diet quality were observed (HEI mean ± SE: 50.0 ± 0.6 v 51.0 ± 0.3, p=0.09); however among females, pasta consumers had significantly lower HEI scores (50.3 ± 0.9 v 52.4 ± 0.3. p=0.01). When the pasta groups were examined separately, consumers of PN had a higher total HEI score (53.6 ± 1.4 v 50.7 ± 0.3, p=0.0385) than non‐consumers; no gender differences were observed. When genders were combined, no overall differences in HEI were observed by PMD, but a small but significant reduction in females was observed (50.0 ± 0.9 v 52.3 ± 0.3, p=0.02). Consumers of MC had a significantly lower HEI (46.9 ± 1.0 v 51.0 ± 0.3, p=0.0003) driven primarily by differences in females (47.9 ± 0.3 v 52.3 ± 0.4, p=0.001). Dietary fiber was higher among all pasta consumers than non‐consumers, (19.2 ± 0.3 vs. 17.3 ± 0.2 g/d, p&lt;0.0001). Similarly, PN (19.8 ± 0.9 vs. 17.5 ± 0.2 g/d, p=0.0132) and PMD (19.7 ± 0.4 vs. 17.3 ± 0.2 g/d, p&lt;0.0001) consumers had higher fiber intakes than non‐consumers of these groups, respectively. Relatively few differences in intakes of calcium, potassium, and vitamin D were observed for overall pasta consumption. Potassium intake was significantly higher (2920 ± 65 mg/d vs. 2771 ± 18, p=0.02) and intake of vitamin D was significantly lower (4.3 ± 0.2 vs. 5.0 ± 0.1 μg/d, p=0.0079) when PN consumers were compared to non‐consumers. In conclusion, better diet quality was only associated with consumption of “Pasta, noodles and cooked grains (with a few exclusions for cooked grains)”; most of the changes in HEI scores resulted from associated lower consumption of solid fats, added sugars, and alcohol calories. Fiber intakes of pasta consumers, regardless of food groupings, were significantly higher. Given that daily fiber intakes in US adults are consistently below recommendations, strategies to increase fiber intake are warranted. Strategies to increase consumption of pasta with vegetables might help to further maximize fiber intakes, improve micronutrient intake, as well as diet quality in the US.Support or Funding InformationFunding provided by Barilla America, Inc.