Low Glycemic Index Research Articles

STUDY OF GLYCEMIC INDEX OF DIABETES-SPECIFIC MODIFIED FORMULA AMONG HEALTHY ADULTS

Background: People with type 2 diabetes incorporate diabetes-specific nutritional formulas (DSNFs) in their nutrition therapy to enhance glycemic control and manage body weight. Among these formulas, the GEN-DM modified formula (GEN-DM MF) has been widely used for several years. However, the glycemic index (GI) of GEN-DM MF has not yet been determined. Objective: This study aimed to assess the GI of GEN-DM MF. Methods: Ten healthy adults with normal oral glucose tolerance were included. The plasma glucose was measured at 0 (baseline), 30, 60, 90 and 120 minutes after consuming 50 grams of glucose solution. On the subsequent two days, plasma glucose measurement was repeated using 84.46 g of GEN-DM MF containing 50 g of carbohydrates. The GI was calculated by dividing the incremental area under the glucose response curve (iAUC) of GEN-DM MF by the area under the glucose response curve of the glucose solution, then multiplying the result by 100. The glycemic load (GL) was calculated by multiplying the GI by the carbohydrate amount in one serving of GEN-DM MF (40 g) /100. Results: Six healthy men and four women with an average age of 35.80 ± 6.89 years, ranging from 28 to 44, were included in the study. The plasma glucose levels at 30 and 60 minutes following the GEN-DM MF were significantly lower than the corresponding glucose levels with p= 0.002 and 0.013, respectively. The GI and GL of GEN-DM MF were 37.75 and 9, respectively, which was classified as low GI and low GL. Conclusion: GEN-DM MF is classified as a low GI and low GL food, which could significantly lower plasma glucose levels among healthy individuals.

Use of flours from traditional pan and salt‐bed‐roasted Kodo grains in the production of breakfast cereal: Spatial, morphological, techno‐functional, structural, and rheological analyses

AbstractKodo millet, possesses the goodness of iron and low glycemic index, notably, its starch has inadequate application owing to retrogradation and low amylose content. Dry‐roasting seems worthy as an inexpensive pretreatment process to preserve desirable textural characteristics of whole cereal grains with peculiarity of moisture levels below 20% for a very short time. The aim of this work was to analyze indepth studies to explain morphological, techno‐functional, structural, and rheological transformation of Kodo starch components generated during roasting of conditioned whole kernels at 15% and 20% initial moisture content (IM). The micrographs displayed a honeycomb‐like structure in all roasted flours. The X‐ray diffraction intensity decreased and showed partial rupture to A‐type orthorhombic crystals of Kodo starch after roasting, while lamellar growth across the multilayer matrix was also generated (23° and 37.35°). The fusion of the starch granules with endosperm's macromolecules observed plausible techno‐functional, and rheological properties, emphasized as non‐nutritional properties substantially improved sensory attributes of food as an additive. Roasted flour at higher IM thus made it easier to integrate into instant ready‐to‐eat breakfast cereals of improved amylose content (23.69%–29.31%) with lowered water activity (.4671–.5170) of varied skin strength (196.17–1894.41 g), elasticity (4.03–10.21 mm), and cell size (164.03–1059.10 μm) detected from puncture‐test force measurement. The infrared absorbance band illustrated loss of peak at 1047 cm−1 and endosperm's expansion (195.34%–309.30%) lowered kernel hardness (42.3–17.78 N) indicated structural loss upon roasting, may significantly reduce milling cost, and provide a commercially pretreated readied kernel or flour for industrial applications.Practical applicationsKodo millet, of the Poaceae family thrives well in abiotic stress and scanty rainfall exhibit meager application owing to low amylose content. Applying preprocessing traditional roasting techniques upon moistened kernel, get popped cereal. Milling of such cereal retards subcellular loss, indicating increased amylose, water, and oil absorption with avid aroma. This is critical in the preparation of cost‐effective dietary formulations for children and geriatrics, thus making it easier for integration into ready‐to‐eat wholesome breakfast cereals.

Psyllium Fibre Inclusion in Gluten-Free Buckwheat Dough Improves Dough Structure and Lowers Glycaemic Index of the Resulting Bread.

The demand for gluten-free (GF) bread is steadily increasing. However, the production of GF bread with improved baking quality and enhanced nutritional properties remains a challenge. In this study, we investigated the effects of adding psyllium fibre (PSY) in varying proportions to buckwheat flour on the dough characteristics, bread quality, and starch digestion properties of GF bread. Our results demonstrate that incorporating PSY contributes to the formation of a gluten-like network structure in the dough, leading to an increase in the gas holding capacity from 83.67% to 98.50%. The addition of PSY significantly increased the specific volume of the bread from 1.17 mL/g to 3.16 mL/g. Bread containing PSY displayed superior textural characteristics and colour. Our study also revealed that the inclusion of PSY reduced the digestibility of starch in GF bread. These findings highlight the positive impact of incorporating PSY into GF bread, suggesting its potential in guiding the production of GF bread with a lower glycaemic index. This may be particularly beneficial for individuals seeking to regulate their blood sugar levels or adopt a low-glycaemic diet.

The impact of addition of pearl millet starch-germ complex in white bread on nutritional, textural, structural, and glycaemic response: Single blinded randomized controlled trial in healthy and pre-diabetic participants

The rise of pre-diabetes at the global level has created a significant interest in developing low glycaemic index food products. The pearl millet is a cheaper source of starch and its germ contains significant amount of protein and fat. The complexing of pearl millet starch and germ by dry heat treatment (PMSGH) resulted an increase in the resistant starch content upto 45.09 % due to formation of amylose-glutelin-linoleic acid complex. The resulting pearl millet starch germ complex was incorporated into wheat bread at 20, 25, and 30 %. The PMSGH incorporated into bread at 30 % reduced the glycaemic index to 52.31. The PMSGH incorporated bread had significantly (p < 0.05)increased in the hardness with a reduction in springiness and cohesiveness. The structural attributes of the 30 % PMSGH incorporated bread revealed a significant (p < 0.05)increase in 1040/1020 cm−1 ratio and relative crystallinity. The consumption of functional bread incorporated with pearl millet starch germ complex reduced blood glucose levels and in vivo glycaemic index in healthy and pre-diabetic participants when compared to white bread. Hence, the study showed that the incorporation of pearl millet starch-germ complex into food products could be a potential new and healthier approach for improving dietary options in pre-diabetes care.

Effect of fibers on starch structural changes during hydrothermal treatment: multiscale analyses, and evaluation of dilution effects on starch digestibility.

Dietary fibers (DFs) may influence the structural, nutritional and techno-functional properties of starch within food systems. Moreover, DFs have favorable effects on the digestive system and potentially a lower glycemic index. These potential benefits may change depending on DF type. Starch processed in the presence of soluble and insoluble fibers can undergo different structural and functional changes, and the present study investigated the effects of short-chain and long-chain inulin and cellulose on the structural and digestive properties of wheat starch. The combined use of differential scanning calorimetry, Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) provided insights into the structural changes in starch and inulin at different levels. Short-chain and long-chain inulin had higher water retention capacity and a potential to limit starch gelatinization. The FTIR results revealed an interaction between starch and inulin. Scanning electron microscopy analysis showed morphological changes in starch and inulin after the hydrothermal treatment. Cellulose fiber was not affected by the hydrothermal treatment and had no influence on starch behavior. The structural differences observed through XRD, FTIR and scanning electron microscopy analyses between starch with and without inulin fibers did not significantly impact starch digestibility, except for the dilution effect caused by adding DFs. The present study highlights the importance of utilizing different analytical tools to assess changes in food samples at different scales. Although short-chain and long-chain inulin could potentially limit starch gelatinization, the duration of the heat treatment (90 °C for 10 min) was sufficient to ensure complete starch gelatinization. The dilution effect caused by adding fibers was the primary reason for the effect on starch digestibility. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Gastrointestinal Bleeding in COVID-19 Infected Patients, and Management Outcomes.

Gastrointestinal bleeding in COVID-19-infection poses unique challenges to patients owing to the high risk of concomitant respiratory failure. However, endoscopic care providers are prone to transmission. This study aimed to understand the risk and management outcomes of gastrointestinal bleeding in COVID-19-infected patients. Data were abstracted from electronic patient medical records, using ICD 10 codes, and demographic and clinical data were collected, for COVID-19-infected patients who developed gastrointestinal (GI) bleeding. Complications related to COVID-19 infection and management outcomes of GI bleeding were studied. Statistically, descriptive analysis was used because of the small sample size. Eighteen COVID-19-infected patients developed episodes of GI bleeding, yielding a prevalence of 0.45%. Their mean age was 74.8 years, 55.5% were female, and 66.6% of patients (n=12) had upper GI bleeding symptoms, predominantly melena (55.5%), followed by coffee ground nasogastric aspirates (n=2). Only two patients (11.11%) had episodes of lower GI bleeding, and the remaining four patients (22.2%) had recurrent acute anemia requiring blood transfusion. The Glasgow-Blatchford score (GBS) at presentation ranged between 6 to 16 (mean 8.8) and seven patients (38.8%) underwent endoscopic evaluation for GI bleeding. The predominant comorbid conditions included hypertension (22.2%), diabetes mellitus (27.7%), chronic kidney disease (50%), ischemic heart disease (33%), atrial fibrillation (11.1%), and peripheral vascular disease (11.1%). The median hospitalization was 24.6 days (range: 3-54 days). The 30-day mortality rate in our cohort was 22.2%, (4/18) mainly noted in older patients aged> 60 years with comorbid conditions and severe COVID-19 infection. The prevalence of GI bleeding observed in our cohort was approximately 0.45%, significantly lower than the global prevalence observed, majority (66%) had upper GI bleeding. The exact reasons for the observed low prevalence of GI bleeding cannot be explained and will be the subject of future research.

ASSESSMENT OF THE QUALITY OF ENRICHED YEAST-FREE BREAD FROM DIFFERENT TYPES OF FLOUR

Today, nutrition is an important factor that determines the state of human health. It is thanks to the right diet that the human body resists the harmful effects of the environment, which affects life expectancy and even the emotional state. The world is facing the issue of the relevance of producing products characterized by high nutritional value and high consumer properties. Bread is accessible to all segments of the population and is one of the most consumed products. There is a growing interest in yeast-free bread, which is widely considered to be healthier and more nutritious, usually contains more vitamins and minerals, and has a lower glycemic index, i.e. less impact on blood sugar levels, making it more beneficial for diabetics The possibility of making yeast-free bread using different types of flour: rye, whole wheat, and first-grade wheat was investigated. The organoleptic characteristics of the prepared bread products were determined. It was found that all the prepared bread samples comply with the regulatory documentation in terms of surface condition, consistency, smell, and taste. Thus, based on the results of the organoleptic tests, all types of flour used in the study can be used for the preparation of yeast-free bread. To increase the nutritional value of bread products, it is proposed to add pumpkin meal, a natural product of plant origin containing more than 50 different biologically active components: a significant amount of proteins, essential amino acids, vitamins, minerals, and dietary fiber, to the recipe of unleavened bread made from different types of flour, which can improve the quality and nutritional value of bread. It has been shown that the addition of meal in the amount of 5% provides excellent organoleptic characteristics for the resulting bread products.

Endoscopy of the Gut: A Window into the Puzzle of Iron-deficiency Anemia

Abstract Background: Iron-deficiency anemia (IDA) is the most common form of anemia which affects almost every age group. It impacts with varied severity the quality of life of the person affected. IDA is caused by either decreased availability of food, especially during times of increased requirement or decreased absorption from the gastrointestinal (GI) tract or increased loss due to various reasons in different age groups. We tried to estimate the prevalence of GI causes in patients with IDA in a tertiary care hospital and describe the clinicopathological profile of the patients with IDA. Materials and Methods: A cross-sectional observational study was conducted in a tertiary care center in Western India on patients suffering from IDA. Male patients of &gt;18 years and female patients &gt;45 years with IDA and no known chronic disease or infection were included in the study and their endoscopic/colonoscopic findings were recorded and analyzed. A biopsy was taken, whenever deemed relevant. Advanced procedures such as enteroscopy or capsule endoscopy were not performed on these patients. Results: A total of 120 patients were evaluated for IDA. At least one GI lesion was found in 42.5% (n = 51) of patients. Upper GI (UGI) lesions (27.5%) were most commonly encountered, followed by lower GI lesions (9.1%). Conclusion: The patients with unexplained IDA were found to have a high incidence of GI lesions (42.5%). Hence, evaluation of the GI system with UGI endoscopy, colonoscopy, and mucosal biopsies in relevant patients is recommended for the determination of the cause of anemia.

Evaluation of green banana pulp drying using infrared radiation with temperature control

The green banana flour (GBF) is a functional food rich in resistant starch and nutrients, probiotic, and has low glycemic index. The obtaining of the flour is usually done in dryers with high energy consumption, and possible deteriorating processes. These problems can be minimized with an adaptive temperature control system in infrared heat sources. The aim of this research was to quantify the energy savings in the production of green banana flour produced by infrared drying compared to the conventional process of drying in a resistance oven. The production of flour from green banana pulp was evaluated using an infrared radiation dryer with fruit surface temperature control (IR-FSTC). The IR-FSTC was performed by keeping the pulp surface at 50 °C and 60 °C. The results were compared with conventional drying using a resistive source. The energy consumption of drying using IR-FSTC was significantly reduced compared to the drying by resistive source and prevented the formation of hotspots. The drying process was also evaluated by physicochemical and spectroscopic analyses of the GBF. The product maintained the pH, titratable acidity, total soluble solids, and lipid content with values similar to those obtained by conventional heating oven drying. In turn, the spectroscopic analyses confirmed the maintenance of biomolecules inherent in GBF. Thus, it is concluded that the results contribute to the sustainable use of energy resources in the production of GBF.

Mapping Lifestyle Interventions for Gestational Diabetes Prevention: A Scoping Review.

The purpose of this study was to conduct a scoping review to map intervention, sample, and physiologic measurement characteristics of lifestyle interventions for gestational diabetes mellitus (GDM) prevention. A total of 19 studies met selection criteria from 405 articles screened (PubMed, Web of Science). No studies were US-based (47% multi-site), and all were delivered in clinical settings. The most targeted nutrition components were low carbohydrate intake (sugar rich foods/added sugars, low glycemic index), low fat intake (mainly low-fat meat, dairy, and saturated fat), and increased fruits and vegetables. Many studies promoted 150min/week moderate-intensity physical activity. Only two studies provided supervised physical activity sessions. Dietitians and nurses were the most common implementers. Samples were characterized as adults with obesity (mean age 31yr, BMI 31kg/m2). Asian populations were predominantly studied. Four studies used theoretical frameworks (75% of which used Social Cognitive Theory). GDM diagnostic criteria set forth by the American Diabetes Association were the most widely used. Insulin sensitivity was commonly assessed via fasting indices. There was a lack of multi-disciplinary, multi-level, and theory-based lifestyle interventions for reducing GDM risk. Addressing these gaps and prioritizing high-risk populations in the US with measurement of traditional and novel biomarkers will advance the field.

Dietary and Metabolic Approaches for Treating Autism Spectrum Disorders, Affective Disorders and Cognitive Impairment Comorbid with Epilepsy: A Review of Clinical and Preclinical Evidence.

Epilepsy often occurs with other neurological disorders, such as autism, affective disorders, and cognitive impairment. Research indicates that many neurological disorders share a common pathophysiology of dysfunctional energy metabolism, neuroinflammation, oxidative stress, and gut dysbiosis. The past decade has witnessed a growing interest in the use of metabolic therapies for these disorders with or without the context of epilepsy. Over one hundred years ago, the high-fat, low-carbohydrate ketogenic diet (KD) was formulated as a treatment for epilepsy. For those who cannot tolerate the KD, other diets have been developed to provide similar seizure control, presumably through similar mechanisms. These include, but are not limited to, the medium-chain triglyceride diet, low glycemic index diet, and calorie restriction. In addition, dietary supplementation with ketone bodies, polyunsaturated fatty acids, or triheptanoin may also be beneficial. The proposed mechanisms through which these diets and supplements work to reduce neuronal hyperexcitability involve normalization of aberrant energy metabolism, dampening of inflammation, promotion of endogenous antioxidants, and reduction of gut dysbiosis. This raises the possibility that these dietary and metabolic therapies may not only exert anti-seizure effects, but also reduce comorbid disorders in people with epilepsy. Here, we explore this possibility and review the clinical and preclinical evidence where available.

Development and Clinical Evaluation of a Low Glycaemic Index Multi-Millet Snack

The prevalence of metabolic disorders, including obesity, diabetes, and high cholesterol, has been closely linked to dietary habits characterized by a high intake of refined carbohydrates and unhealthy fats. Addressing this issue through healthy eating practices is crucial in preventing the onset of these disorders. However, popular snacks in society often contribute to unhealthy diets. In response, this study aimed to develop a nutritious multi millet snack using food technologies like protein extraction, extrusion puff technology, tumble blending and no-fry oil treatment. The nutritional analysis revealed high protein and high fibre content, as well as a low-fat profile. Clinical evaluation of the snack on 16 human volunteers demonstrated a low glycemic index (GI) 45.7, indicating slower sugar release into the bloodstream. The experiment's outcome presents a promising avenue for promoting health-conscious and diabetic-friendly dietary choices. The study underscores the potential of combining food technologies with millet-based formulations to create foods that align with the needs of individuals seeking to maintain or improve their metabolic health. Further investigations and long-term studies are needed to evaluate benefits of this multi millet snack on cholesterol and obesity when used as a replacement to regular dietary practices Key Words: Food technology, Millet, Snack, healthy, Low Glycemic index, GI

Efficacy of daily versus intermittent low glycemic index therapy diet in children with drug-resistant epilepsy: A randomized controlled trial

IntroductionThe predominant reason for the discontinuation of low glycemic index therapy (LGIT) in children with epilepsy is the dietary restrictions imposed therein. This trial intended to compare the efficacy of daily and intermittent LGIT in children with drug-resistant epilepsy (DRE). MethodsThis study was performed between February 2018 and January 2019 to compare the efficacy of daily and intermittent LGIT in children aged 1–15 years with DRE following 24 weeks of dietary therapy. Compliance, the difficulty faced by caregivers, adverse effects, impact on behaviour, and social quotient in both arms were compared. Children in the intermittent LGIT arm received a liberalized diet for two days every week (Saturday and Sunday), which also allowed medium glycemic index foods. Carbohydrate calories were allowed up to 20% of the total caloric requirement in the liberalized diet, as compared to only 10% in standard LGIT. ResultsOut of 132 children randomized (66 in each group), 122 completed 24 weeks follow up. Mean weekly seizure frequency reduction at 24 weeks in the intermittent LGIT group was comparable with that of the daily LGIT group in both intention-to-treat (ITT) and per-protocol analysis (−50.95%± 22.34% vs −47.16%± 23.41%, p=0.36 in ITT and −53.88%±20.54% vs −49.20%±21.87%, p=0.23) in per-protocol analysis for intermittent and daily LGIT group respectively). The proportion with ≥50% reduction in seizure frequency was also comparable between both groups (p=0.73 and 0.56 in ITT and per protocol analysis respectively). The proportion of patients with adverse events and satisfactory compliance rate also had a trend towards favoring intermittent LGIT (p=0.06 and 0.51, respectively), while caregiver difficulty was lower with intermittent LGIT (p=0.001). ConclusionsIntermittent LGIT is comparable to daily LGIT in terms of seizure frequency reduction after 24 weeks of dietary therapy. Trial registrationClinicalTrials.gov (Registration number- NCT03464487, https://clinicaltrials.gov/ct2/show/NCT03464487).

Development of Millet Dip Stick (Samai, Thinai, Kambu) and Analyse the Sensory Acceptability

Nutrient loss occurs in the body when there is Protein-Energy Malnutrition (PEM).For children in underdeveloped countries, it is the leading cause of death. Protein-calorie malnutrition, or PEM, is another term for it. It manifests in children whose dietary intake of energy and protein is inadequate to meet their needs. Millets are considered a healthy food for developing kids and an excellent weaning food for babies. It’s high in protein. Hence, it supports children’s muscular development and growth. It has little simple sugars, a lot of fiber, and few carbohydrates. As a result, it has a lower glycemic index than wheat or rice and results in lower blood sugar levels. A biscuit is a flour-based and shaped food product. The biscuits are great for quelling children’s sudden hunger sensations and can even be eaten by adults. Concerned about their child’s protein consumption, many parents search for nutritional supplements. To fulfil the nutritional requirements, millet biscuits are ideal. Iron is abundant in moringa leaves. Millet biscuits are the best option to provide the necessary nutritional intake. Moringa leaves are rich in iron. For this project, we created a dip using powdered moringa leaves and biscuits made with little, foxtail, and pearl millet. It is a healthy treat that is perfect for children.

Pasting Characteristics and In Vitro and In Vivo Digestibility of Low‐, Medium‐, and High‐Amylose Types of Mung Bean Flour after Heat‐Moisture Treatment

AbstractMung bean (Vigna radiata L.) flour varieties of varying amylose content are heat‐moisture treated at 100 °C for 6 h, and changes in their pasting properties and digestibility are investigated. Amylose content of the low‐amylose (LAM MB), medium‐amylose (MAM MB), and high‐amylose mung bean flour (HAM MB) is 16.1%, 23.2%, and 31.7%, respectively. Mung bean flour after heat‐moisture treatment (HMT) shows significantly reduced peak and breakdown viscosities and swelling power compared to those in native flours. However, pasting temperature, final and setback viscosities, and solubility of the mung bean flour significantly increase after HMT. The treated mung bean flour also contains higher amounts of resistant starch (RS, 19.6%–30.6%) than that in the corresponding untreated flour (14.9%–17.5%). Consequently, mung bean flour subjected to HMT induces a lower blood glucose response in mice and exhibits lower glycemic index (GI) values than that of untreated flour. Among all mung flour types subjected to HMT, the HAM MB exhibits the highest viscosity, solubility, and swelling power and has the highest RS content (30.64%), and the lowest blood glucose response and GI value. Thus, mung bean flour after HMT with desirable properties and digestibility can be used in the production of low‐carbohydrate foods.

A115 EVALUATING THE CONTENT AND FACE VALIDITY OF LOW-COST GEL POLYPS FOR POLYPECTOMY SKILLS TRAINING IN NOVICE ENDOSCOPISTS

Abstract Background Polypectomy is an essential endoscopic skill involving the removal of potentially premalignant lesions during colonoscopy. The ad hoc nature of polyp encounters is a significant barrier to polypectomy training, as this limits the ability to deliberately practice the skill. Effective and accessible polypectomy simulators may improve global implementation of polypectomy curricula. Aims To determine the face and content validity of a novel low-cost gel polyp simulator for use in endoscopic training programs. Methods A novel gel polyp simulator with multiple polyp morphologies based on the Paris classification was developed and used with a commercially available colonic phantom (Koken Lower GI Endoscopy Simulator Type II LM-107, Koken CO.LTD, Japan) in an endoscopy simulation-based training course (July, 2023). Feedback based on previous prototypes of the simulator were implemented into the simulator utilized in the present study. Novice (ampersand:003C25 procedures) and expert (ampersand:003E1000 procedures) endoscopists performed simulated procedures with the gel polyps. Using a five-point Likert scale (“strongly agree” to “strongly disagree”), a post-training survey based on previously published surveys used to determine the face and content validity of low-cost physical colonic simulators was administered. A section for additional comments was placed at the end of the survey. Results The face and content validity survey was completed by 3 experts and 21 novices. The median score for all face validity questions was 5 (IQR 5-5) from experts and 5 (IQR 5-5) from novices. The median score for all content validity questions was 5 (IQR 5-4) from experts and 5 (IQR 5-5) from novices. In the additional comments section of the survey, one expert commented that future iterations of the gel polyps should be made thicker so that trainees could practice using endoscopic clips. The gel polyp simulator cost $0.61 CAD/polyp including the cost of materials and 3D printed molds. Conclusions The gel polyp simulator appears to be a feasible modality for polypectomy training that is reproducible using accessible and low cost materials. Face and Content Validity Survey (questions and median survey score) Funding Agencies None

Glycation of tilapia protein hydrolysate decreases cellular antioxidant activity upon in vitro gastrointestinal digestion

Changes in structural characteristics and antioxidant activity of tilapia hydrolysate glycated with glucose, fructose, or xylose at 90 °C for 12 h, and following in vitro gastrointestinal (GI) digestion were investigated. Fourier-transformed infrared (FTIR) band between 1,800 and 1,400 cm−1 confirmed the structural modifications of hydrolysate under glycations. Glycation drastically increased ATBS·+ and ONOO- scavenging activities (p < 0.05) as well as ferric-reducing antioxidant power (FRAP). Xylose was the most effective sugar for glycation, yielding the highest chemical antioxidant activities (p < 0.05). However, glycated hydrolysates exhibited lower cellular antioxidant activity (CAA) on HepG2 cell when compared to hydrolysates. The extensive glycation of hydrolysates resulted in lower GI digestibility as confirmed by the FTIR spectra of CO, CN, NH, CC, CO, and CH stretching vibrations. Glycation of tilapia hydrolysates only improved chemical antioxidant activities, but alleviated CAA, especially upon simulated GI digestion.

Questionnaire-based exposome-wide association studies for common diseases in the Personalized Environment and Genes Study.

The exposome collectively refers to all exposures, beginning in utero and continuing throughout life, and comprises not only standard environmental exposures such as point source pollution and ozone levels but also exposures from diet, medication, lifestyle factors, stress, and occupation. The exposome interacts with individual genetic and epigenetic characteristics to affect human health and disease, but large-scale studies that characterize the exposome and its relationships with human disease are limited. To address this gap, we used extensive questionnaire data from the diverse North Carolina-based Personalized Environment and Genes Study (PEGS, n = 9, 429) to evaluate exposure associations in relation to common diseases. We performed an exposome-wide association study (ExWAS) to examine single exposure models and their associations with 11 common complex diseases, namely allergic rhinitis, asthma, bone loss, fibroids, high cholesterol, hypertension, iron-deficient anemia, ovarian cysts, lower GI polyps, migraines, and type 2 diabetes. Across diseases, we found associations with lifestyle factors and socioeconomic status as well as asbestos, various dust types, biohazardous material, and textile-related exposures. We also found disease-specific associations such as fishing with lead weights and migraines. To differentiate between a replicated result and a novel finding, we used an AI-based literature search and database tool that allowed us to examine the current literature. We found both replicated findings, especially for lifestyle factors such as sleep and smoking across diseases, and novel findings, especially for occupational exposures and multiple diseases.

Diet in secondary prevention: the effect of dietary patterns on cardiovascular risk factors in patients with cardiovascular disease: a systematic review and network meta-analysis

BackgroundImproving dietary habits is a first-line recommendation for patients with cardiovascular disease (CVD). It is unclear which dietary pattern most effectively lowers cardiovascular risk factors and what the short- and long-term effects are. Therefore, this network meta-analysis compared the effects of popular dietary patterns on cardiovascular risk factors in patients with established CVD.MethodsA systematic search of PubMed, Embase, the Cochrane library, SCOPUS and Web of Science was conducted up to 1 April 2023. Randomized controlled trials (RCTs) comparing the effect of popular dietary patterns (Mediterranean, moderate carbohydrate, low glycemic index, low-fat and minimal dietary intervention) on cardiovascular risk factors (body weight, systolic blood pressure, lipids) in CVD populations were selected. A random-effects network meta-analysis was performed.ResultsSeventeen RCTs comprising 6,331 participants were included. The moderate carbohydrate diet had the most beneficial effect on body weight (-4.6 kg, 95%CrI -25.1; 15.8) and systolic blood pressure (-7.0 mmHg 95%CrI -16.8; 2.7) compared to minimal intervention. None of the included dietary patterns had a favorable effect on low-density lipoprotein cholesterol. After 12 months, the effects were attenuated compared to those at < 6 months.ConclusionsIn this network meta-analysis of 17 randomized trials, potentially clinically relevant effects of dietary interventions on CV risk factors were observed, but there was considerable uncertainty due to study heterogeneity, low adherence, or actual diminished effects in the medically treated CVD population. It was not possible to select optimal dietary patterns for secondary CVD prevention. Given recent clinical trials demonstrating the potential of dietary patterns to significantly reduce cardiovascular event risk, it is likely that these effects are effectuated through alternative physiological pathways.

Flares of acute graft-versus-host disease: a Mount Sinai Acute GVHD International Consortium analysis

AbstractThe absence of a standardized definition for graft-versus-host disease (GVHD) flares and data on its clinical course are significant concerns. We retrospectively evaluated 968 patients across 23 Mount Sinai Acute GVHD International Consortium (MAGIC) transplant centers who achieved complete response (CR) or very good partial response (VGPR) within 4 weeks of treatment. The cumulative incidence of flares within 6 months was 22%, and flares were associated with a higher risk of nonrelapse mortality (NRM; adjusted hazard ratio [aHR], 4.84; 95% confidence interval [CI], 3.19-7.36; P < .001). Flares were more severe (grades 3/4, 41% vs 16%; P < .001) and had more frequent lower gastrointestinal (LGI) involvement (55% vs 32%; P < .001) than the initial GVHD. At CR/VGPR, elevated MAGIC biomarkers predicted the future occurrence of a flare, along with its severity and LGI involvement. In multivariate analyses, higher Ann Arbor (AA) biomarker scores at CR/VGPR were significant risk factors for flares (AA2 vs AA1: aHR, 1.81 [95% CI, 1.32-2.48; P = .001]; AA3 vs AA1: aHR, 3.14 [95% CI, 1.98-4.98; P < .001]), as were early response to initial treatment (aHR, 1.84; 95% CI, 1.21-2.80; P = .004) and HLA-mismatched unrelated donor (aHR, 1.74; 95% CI, 1.00-3.02; P = .049). MAGIC biomarkers also stratified the risk of NRM both at CR/VGPR and at the time of flare. We conclude that GVHD flares are common and carry a significant mortality risk. The occurrence of future flares can be predicted by serum biomarkers that may serve to guide adjustment and discontinuation of immunosuppression.