Low Glycemic Index Research Articles

An Age-Stratified Analysis of Early Postoperative Mortality Among Medicare-Eligible Patients With Common Gastrointestinal and Hepato-pancreato-biliary Malignancies.

Background: The frequency of major cancer surgery in the elderly (≥80years) has increased concomitantly with the rise in average age of the population. We assessed early postoperative mortality following hepato-pancreato-biliary (HPB) and gastrointestinal (GI) procedures for common malignancies stratified by age. Methods: The National Cancer Database (2004-2017) was queried for patients who underwent resection for GI (gastroesophageal and colorectal) or HPB (pancreatic adenocarcinoma, biliary tract, and primary liver) cancers. We compared early postoperative mortality (30d and 90d) stratified by age (65-79 vs ≥80years) and procedure, and compared survival outcomes by age and operative vs nonoperative management. Results: A total of 709,358 patients were included. The 30-day mortality ranged from 1.8% to 5.8% among patients 65-79years and from 3.2% to 12.4% among patients ≥80years depending on procedure. The 90-day mortality ranged from 3.6% to 10.6% in patients 65-79years compared to 8.4%-21.0% among patients ≥80years. The overall 90-day mortality was 5.2% for patients 65-79years and 12.0% for patients ≥80years (P < .001). Age ≥80 was associated with worse survival among operatively managed patients with each upper GI, HPB, and lower GI malignancy relative to younger patients on multivariable analysis. However, operative management of patients ≥80years was associated with improved survival relative to nonoperative management. Discussion: Elderly patients suffer higher postoperative mortality after major GI and HPB cancer surgery, but operative management is associated with improved survival among patients ≥80years as compared to nonoperative management. These data are important to contextualize when counseling elderly patients on their treatment options for localized GI and HPB cancers.

Evaluation of glycemic response of ten local meals commonly consumed from Chad

Diabetes mellitus is a metabolic disorder characterized by the presence of chronic hyperglycaemia accompanied by greater or lesser impairment in the metabolism of carbohydrates, lipids and proteins, including defects in either insulin secretion or response. The function of pancreatic cells gradually declines before the onset of clinical hyperglycemia. Its prevalence is increasing everywhere, especially in the developing countries due to the consumption of unknown glycemic index (GI) foods. Thus, the present study aimed to determine the GI of some local meals from Chad. In this purpose, ten meals were investigated and 60 non-diabetic volunteers were recruited in the present study. The proximate composition and the GI of these meals were determined. Results showed that 5 main ingredients (Hibiscus esculentus, Ipomea batata, Hibiscus sabdariffa, Corchorus oletorius and seeds of Parkia biglobosa) differentiate the meals. Soluble sugars and total carbohydrates levels showed a significant (p < 0.05) difference between meals (staples and sauces). The highest value of total carbohydrate of staples was found in Peeled dried sorghum ((BD); 31.80 %) while Cooked rice ((RZ); 19.82 %) has the lowest amount. Then, total carbohydrate content of sauces was in the range of 3.95 % (Leaves of Corchorus oletorius (MLK)) and 8.76 % (Dried okra + Fresh meat (GSV)) while, Sorrel leaves + Smoked fish ((OSP); 2.51 %) and Dried okra + Smoked fish ((GSP); 1.31 %) recorded the highest and lower values of soluble sugars, respectively. Moreover, Peeled dried maize + Dried okra + Fresh meat (MD/GSV) meal showed the highest GI (115.76 %) while the lowest value was found with Cooked rice + Sorrel leaves + Smoked fish (RZ/OZP) meal (31.08 %). The GI of Peeled dried maize + Fresh okra + Fresh meat (MD/GFV) attained a peak of 140 at 40 min while the peak of 130 was obtained with Peeled dried maize + Fresh okra + Smoked fish (MD/GFP) meal at the same time compared to glucose (160 at 40 min). Five meals (OSP/RZ; MD/GFP; MD/GFV; BD/GFP and BD/MLK) were low GI foods and were the best meals for human-being in terms of preventing diabetes mellitus. The consumption of such meals can provide a substantial contribution to the improvement of the Chadian diets.

Exploring the Association between Benign Anorectal Conditions and Colorectal Cancer from the Analysis of Lower Gastrointestinal Endoscopies

Abstract Objective Patients experiencing hemorrhoids or fissures may overlook other gastrointestinal (GI) symptoms, assuming that they are linked solely to their existing condition. However, colon cancer, often asymptomatic, can coincide with benign pathologies detected during colonoscopy. This study investigates the prevalence of colorectal cancer (CRC) in patients undergoing lower GI endoscopy for hemorrhoids and elucidates the correlation between cancer and benign pathologies identified during colonoscopy. Highlighting its potential to reveal hidden cancers emphasizes the critical role of colonoscopy in comprehensive health care. Methods The primary objective was to thoroughly investigate the prevalence of CRC in patients who underwent lower GI endoscopy for hemorrhoids. A comprehensive analysis was conducted using a dataset spanning 7 years of lower GI endoscopy. The main focus of this investigation was to determine the incidence of cancer. Additionally, a meticulous examination of accompanying benign diagnoses was performed to provide a comprehensive evaluation. Results The study cohort, comprising 6,268 patients, revealed a noteworthy coexistence of malignancies with common conditions. The revelation was of paramount significance that the total number of malignant cases within this cohort was 440. Polyps emerged as the most frequently observed condition, constituting 55.2% (n = 243) of the cases. Diverticulosis was present in 6.6% (n: 29) of cases, while ulcerative colitis was detected in 8% (n: 2) of cases. Hemorrhoids were identified in 20.7% (n: 91) of cases. The findings indicated a substantial association between these common conditions and malignancy. Specifically, it was discovered that approximately 1 in 22 individuals with hemorrhoids, 1 in 52 individuals with fissures, and 1 in 5.7 individuals with polyps were diagnosed with malignancy. Conclusion This study highlights the pivotal role of colonoscopy in uncovering hidden cancers, especially in patients with hemorrhoids. The findings emphasize the significance of doctors and patients prioritizing colonoscopy, as it allows for early detection and intervention for potential malignancies, even in the presence of hemorrhoids.

Influence of baking time and formulation of part-baked wheat sourdough bread on the physical characteristics, sensory quality, glycaemic index and appetite sensations.

Raw materials and process parameters in bread production can modulate the glycemic index, which on itself has been linked with provision of better hunger satisfaction and maintaining better satiation. The objective of this research was to investigate if using unrefined wheat flour or the addition of intact cereals in formulation or alternating the baking time would have an effect on physical characteristics, sensory quality, glycaemic index and appetite sensations in wheat sourdough bread. In the study, three types of commercial part-baked frozen sourdough bread, baked to the final baking for two different times (long and short baking time) were used. A randomized controlled crossover trial was performed with 10 healthy adults who consumed sufficient quantity of bread to ingest 50 g available carbohydrates. Participants self-reported appetite sensations (desire to eat, hunger, fullness, satisfaction, appetite) on a 10 cm visual analog scale (VAS) scale in a course of 180 min. In addition, bread products were subjected to overall acceptability and different sensory attributes were examined on JAR "just about right" scale. Different bread formulations (refined flour, unrefined wheat flour, cereal flour or intact cereals) and different length of baking time significantly influenced (p < 0.005) physical, textural and sensory features of products. The alternation of aforementioned parameters decreased the glycemic index, but not significantly (p > 0.005). No correlation was found between lower GI, satiety and satiation. Liking score and incremental area under the curve (iAUC) of satiety and satiation were calculated as highest in sourdough bread with added cereals.

Low glycaemic index diet in pregnancy and child asthma and eczema: follow-up of the ROLO trial

Atopic diseases, including asthma and eczema, represent a substantial public health problem in children and adolescents globally; asthma is the commonest chronic disorder of childhood(1). Research suggests that the origins of childhood asthma lie in utero, and several components of the maternal diet during pregnancy have been investigated in relation to atopic outcomes in children. Epidemiological evidence suggests that a higher intake of sugar during pregnancy is associated with a higher risk of childhood asthma and atopy(2,3). However, randomised trial evidence supporting such a link is lacking.Aims 1.To examine whether a low glycaemic index (GI) dietary intervention during pregnancy decreases the risk of asthma and eczema in childhood.2.To assess observationally whether maternal intake of sugar during pregnancy is positively associated with asthma and eczema in childhood.This is a secondary analysis of children from the ROLO trial. Healthy women were randomised to receive an intervention of low GI dietary advice or routine antenatal care from early pregnancy. All women completed a 3-day food diary in each trimester of pregnancy. Estimates of maternal intake of sugar in each trimester were averaged to provide mean intakes during pregnancy. Mothers reported current doctor-diagnosed eczema in their children at 2-years of age (n=271), and current doctor-diagnosed asthma and eczema in their children at 5 (n=357) and 9-11 years (n=391) of age. Multivariable logistic regression models were used a) to test the effect of the intervention on child outcomes overall, and stratified by maternal education level (with, versus without, a complete tertiary level education), and b), in observational analyses, to analyse the relation between sugar and carbohydrate intake in pregnancy and child outcomes.There was weak evidence overall for a reduction in asthma at 5-years of age in children whose mothers received the low GI dietary intervention during pregnancy compared to usual care [adjusted odds ratio (OR) 0.43 (95% CI 0.18, 1.03); P=0.06]. However, in stratified analyses the intervention was associated with a marked reduction in risk of asthma at 5-years of age in children born to mothers with lower educational attainment [adjusted OR 0.16 (0.03, 0.85); P=0.032]. Intake of sugar during pregnancy was positively associated with the development of asthma at any time point in childhood [adjusted OR per quartile of mean sugar intake 1.40 (0.99, 1.97), P-trend=0.048] and at 5-years of age [adjusted OR per quartile 1.55 (1.00, 2.40), P-trend=0.046]. No associations with eczema outcomes were found.This novel study provides stronger evidence that higher sugar intake during pregnancy is associated with an increased risk of asthma among offspring. An intervention to reduce sugar intake in pregnancy may have potential as a primary prevention strategy, particularly amongst children born to mothers with lower educational attainment.

Characterisation of Pea Milk Analogues Using Different Production Techniques.

Among legumes, peas are characterised by their high protein content, low glycaemic index and exceptional versatility. However, their potential as a food is often compromised by their undesirable off-flavour and taste. Hence, this study focuses on minimising off-flavours through simple pretreatments with the aim of improving the potential for the production of pea milk analogues. Pea milk analogues are a burgeoning type of plant-based milk alternatives in the growing plant-based market. Pea seeds were subjected to different pretreatments: (i) dry milling, (ii) blanching followed by soaking in alkaline solution and subsequent dehulling and (iii) vacuum. Typical physicochemical properties such as pH, viscosity, colour, titratable acidity and yield were measured to obtain a brief overview of the products. Consumer acceptance test, descriptive sensory analysis, gas chromatography-mass spectrometry and gas chromatography-olfactometry were used to map the complete sensory profile and appeal of the pea milk substitutes. The L* values of the pea milk analogues were significantly lower than those of cow's milk, while a*, b*, viscosity and pH were similar. In the descriptive sensory analysis, sweet, astringent, pea-like, cooked, hay-like, boiled corn and green notes received relatively higher scores. The vacuum-treated pea milk analogues received higher scores for flavour and overall acceptability in the consumer acceptance test. The pretreatments resulted in significant changes in the volatile profiles of the pea milk analogues. Some volatiles typically associated with off-flavour, such as hexanal, were found in higher concentrations in blanched pea milk analogues. Among the applied pretreatments, vacuum proved to be the most effective method to reduce the content of volatile off-flavour compounds. This study stands out as a rare investigation to characterise pea milk analogues and to evaluate the impact of simple pretreatments on the improvement of their sensory properties. The results of this study could contribute to the development of milk alternatives that offer both high nutritional value and strong appeal to consumers.

Experience of personalizing cancer treatment in economically-constrained and resource-restricted community oncology practice in India through cost-effective broad spectrum NGS and survival outcomes: An observational study of 3 years.

e15173 Background: NGS based mutational findings are increasingly used in oncology practice to personalize treatment strategies. We elucidate the impact of comprehensive genomic profiling and the new avenues it opens for personalized precision medicine. Methods: This was a retrospective study evaluating patients who underwent a cost-effective (&lt;US $1000), inhouse developed comprehensive NGS test. Descriptive data was tabulated &amp; mutational distribution, therapeutic strategies and survival outcomes were evaluated. Results: A total of 336 patients were evaluated from a community oncology practice over the last 3 years in Western India. The mean age was 59.2 years; with F:M being 1.04:1 and stage distribution being 3.5%, 5.9%, 9.5% and 80.9% for Stage I, II, III and IV respectively. Comprehensive NGS was performed to evaluate SNVs, CNVs, and indels spanning across over 15000 loci for 1080 tumor specific genes wherein 71.7% were tissue-based, 24.4% were liquid biopsy-based and 3.8% were combined tissue-DNA and ctDNA-based analysis. Majority (69.9%) of the patients were pre-treated while 30% were therapy naïve. The most common cancers evaluated were Lung (18.1%), Pancreatobiliary (15.1%), Breast (11.3%), Gynaec (9.5%), and Lower GI (9.5%). Pathogenic mutations were reported in 83.6% of the cohort while in 16.3% no mutations were detected. Most common mutations observed in this retrospective study were TP53 (38.3%), KRAS (16.6%), PIK3CA (9.5%), EGFR (7.4%) and PTEN (5.6%); and the distribution was largely similar in untreated as well as pre-treated cohorts. Furthermore, genomic alterations for each cancer type are described in Table 1. MSI high and TMB high (&gt;10) were reported in 0.5% and 7.4% respectively. PDL1 positive IHC was reported in 3.2% of tissue samples, whereas HRD high (&gt;50) was reported in 2.3% of the cohort of which the majority (11.5%) were from Upper GI tumors. Targetable genomic alterations were detected in 53.8% (181/336) of which 38.1%(69/181) received the suggested targeted therapy. Clinical response was seen as PR in 14.4% and CR in 2.8% of patients. Of 336 patients 4.76% received modified therapeutic regimens which differed from the standard of care, wherein median PFS was 8 mo [CI 95% (5.3-10.7)] while median OS was 55.1 mo [CI 95% (25.8-NA)]. Conclusions: This observational study outlines the potential benefit of personalizing treatment regimens in the management of solid organ cancers, especially in scenarios where standard-of-care regimens may have failed and the need to incorporate broad-spectrum NGS. [Table: see text]

Cytomegalovirus-Associated Colitis as a Cause of Lower Gastrointestinal Bleeding in Kidney Transplant Recipients: A Single-Centered Study.

Introduction Cytomegalovirus (CMV) is the most common viral pathogen affecting patients undergoing solid organ transplantation. It is often the most important infection for patients who have undergone kidney transplantation. Clinical presentations of cytomegalovirus infection range from asymptomatic infection to organ-specific involvement. This study aimed to determine the frequency of cytomegalovirus-associated colitis in kidney transplant recipients (KTRs) presenting with lower gastrointestinal bleeding. Methods After the approval of the ethical review committee of the Sindh Institute of Urology and Transplantation (ERC-SIUT), this cross-sectional study was conducted at the Department of Hepatogastroenterology at the Sindh Institute of Urology and Transplantation from January 2021 to December 2021. All the KTRs (six months after the transplantation) of either gender and aged between 18 and 65 years, presenting with lower gastrointestinal (GI) bleeding as per the operational definition, were enrolled in the study. Those patients who were either unfit for the endoscopy or refused to give consent were excluded from the study. Colonic biopsies were reviewed by a consultant histopathologist for the features of CMV infection. Results A total of 95 renal transplant recipients of either gender or age above 18 to 65 years with lower GI bleeding were included in the study. Among them, 84 (88.4%) were males, while 11 (11.6%) were females. The mean age of the patients included in the study was 37±11 years. The most common presenting complaint was fresh bleeding per rectum, which was observed in 73 (76.8%). The most common findings observed on colonoscopy in KTRs with bleeding per rectum were colonic ulcers and erosions noted in 41 (43.1%) and 36 (37.3%) patients, respectively. On histopathology, CMV colitis was noted in 21 (22.1%) patients. On comparison of different baseline variables, the presence of fresh bleeding per rectum and the presence of both ulcers and erosions on colonoscopy were the factors significantly associated with CMV colitis in KTRs. Conclusion CMV colitis is a prevalent condition in KTRs, presenting with lower GI bleeding. Despite the significant occurrence, the levels of CMV viremia were not associated with CMV colitis, suggesting that diagnosis should rely on histopathological confirmation. Prophylaxis during periods of high immunosuppression is crucial to reducing the incidence of CMV infections and improving both graft function and patient survival.

Outcomes of colorectal cancer hospitalization with and without coexisting nutritional anemia: A National Inpatient Sample (NIS) 2016 to 2019 database study.

e15648 Background: Colorectal carcinoma (CRC) is third most commonly diagnosed cancer in males and second in females. Implications of CRC with coexisting anemia and its outcomes of hospitalization have not been studied. We aim to evaluate the outcomes of CRC hospitalization with and without coexisting nutritional anemia. Methods: A total of 504,515 patients (male: 52.61%, female: 47.39%), aged ≥18 years, admitted from 2016 to 2019 with principal admission diagnosis of CRC were identified using International Classification of Disease 10 (ICD-10) coding for NIS database. Patients were stratified into those with and without nutritional anemia (16.19% vs 83.81%) which included iron, B12, folate deficiency and other nutritional anemia per ICD-10 coding. Mortality was the primary outcome of the study whereas length of stay (LOS), total treatment cost, acute kidney injury (AKI), pulmonary embolism (PE), deep vein thrombosis (DVT), colonoscopy, abdominal surgery and lower gastrointestinal (GI) bleeding were secondary outcomes. Multivariate regression model was used to estimate the outcomes of CRC hospitalization with and without coexisting nutritional anemia after adjusting for confounders like age, sex, race, insurance provider, co-morbidities, median income, hospital region, location, etc. Results: Mean age of patients admitted with CRC with and without anemia was 69.06 and 65.77 years respectively. Among two groups, mortality was significantly lower among patients with nutritional anemia (2.05 % vs 2.64 %). Lower GI bleeding (12.24% vs 4.77%) and colonoscopy during inpatient stay (43.97% vs 23.05%) were significantly higher among CRC cohort with nutritional anemia. Similarly, LOS, cost of inpatient hospitalization, AKI, PE and DVT were also significantly higher among anemia cohort. However, the need for abdominal surgery was significantly higher among CRC patients without nutritional anemia. Table 1 summarizes the results of multivariate regression analysis. Conclusions: Nutritional anemia in CRC patients is associated with longer length of stay, increased cost, higher risk of developing venous thrombosis along with lower GI bleed and colonoscopy. Therefore, it should be corrected to optimize outcomes among CRC patients. [Table: see text]

A multicenter, retrospective study of a through-the-needle injection–capable electrosurgical knife for endoscopic submucosal dissection

Endoscopic submucosal dissection (ESD) is a technically challenging resection technique for en bloc removal of dysplastic and early cancerous GI lesions. We conducted a single-arm retrospective study evaluating the safety and efficacy of a new through-the-needle injection-capable electrosurgical knife used in upper and lower ESD procedures performed at 6 U.S. academic centers. Data were retrospectively collected on consecutive cases in which the new ESD knife was used. The primary efficacy endpoint was successful ESD (en bloc resection with negative margins). Secondary efficacy endpoints included en bloc resection rate, curative resection rate, median ESD time, and median dissection speed. The safety endpoint was device- or procedure-related serious adverse events. ESD procedures of 581 lesions in 579 patients were reviewed, including 187 (32.2%) upper GI and 394 (67.8%) lower GI lesions. Prior treatment was reported in 283 (48.9%) patients. Successful ESD was achieved in 477 (82.1% of 581) lesions-lower for patients with versus without submucosal fibrosis (73.6% vs 87.0%, respectively; P< .001) but similar for those with versus without previous treatment (81.7% vs 82.3%, respectively; P= .848). A total of 443 (76.2% of 581) lesions met criteria for curative resection. Median ESD time was 1.0 (range, 0.1-4.5) hour. Median dissection speed was 17.1 (interquartile range, 5.3-29.8) cm2/h. Related serious adverse events were reported in 15 (2.6%) patients, including delayed hemorrhage (1.9%), perforation (0.5%), or postpolypectomy syndrome (0.2%). A newly developed through-the-needle injection-capable ESD knife showed a good success rate and excellent safety at U.S. (Clinical trial registration number: NCT04580940.).

The heavy implications of racial and socioeconomic factors affecting cachexia incidence at gastrointestinal malignancy diagnosis: A single-institution study.

e13694 Background: Cachexia, a complicated metabolic syndrome often related to cancer, is associated with anorexia, decreased quality of life, and increased mortality in advanced disease. The overall prevalence of cachexia ranges from 40% at cancer diagnosis to 70% in advanced disease. Our team aimed to determine whether racial and socioeconomic factors are associated with incidence of cachexia or being underweight at diagnosis (UAD) in patients with gastrointestinal (GI) tract cancer in a diverse, multiethnic urban medical center with high Asian-American representation. Methods: Using ICD-10 codes, adult (age ≥18) patients with diagnosis of primary GI carcinoma between 1/1/2013 to 12/31/2022 were identified. Those with secondary GI involvement from non-GI malignancies were excluded. Patient height, weight at time of diagnosis (weight measured within 4-week window from pathologic diagnosis date), and highest weight within 6 months preceding diagnosis date were recorded. Demographic data included: race, primary language, tumor origin, cancer stage and social deprivation index (SDI). Cachexia was defined as weight loss within a 6-month period of &gt;5% of initial body weight, or weight loss &gt;2% if body mass index (BMI) was &lt;20kg/m2. UAD was defined as BMI &lt;18.5kg/m2 at the time of diagnosis. Results: Of 718 patients with newly diagnosed GI cancer, 366 were analyzable for weight change. 61.2% were male. Race distributions were: 62.0% White, 23.8% Asian, 11.5% Black, and 2.7% Other. The primary languages spoken were: 76.5% English, 19.4% Asian-language, and 4.1% Other. The tumor originated from the following areas: 63.7% lower GI tract, 27.0% upper GI tract, and 8.5% hepato-pancreaticobiliary. 8.5% were UAD and 26.4% met criteria for cachexia at the time of diagnosis. Race and UAD had a significant association; Asians (p=.002) and those speaking Asian languages (p&lt;.001) were more likely to present UAD. However, no significant relationship existed between race (p=.780) or language group (p=.656) on cachexia incidence. Tumor origin groups trended towards differences in cachexia incidence (p=.061). Mean SDI was significantly higher in those who were UAD (p=.026). The SDI was slightly higher among those who had cachexia, but this was not statistically significant (p=.244). Conclusions: GI cancer patients of Asian race, who primarily speak an Asian language, and those with higher SDI are more likely to present UAD, but these same factors are not associated with incidence of cachexia at diagnosis. Additional research is needed to determine if being UAD is associated with development of cachexia later in the illness trajectory or affects clinical outcomes for patient with GI cancer.

Exploring the Nutritional Impact of Sourdough Fermentation: Its Mechanisms and Functional Potential.

Sourdough fermentation is one of the oldest traditional methods in food technology and occurs as a result of fermentation of flour prepared from grains. The nutritional role of sourdough is related to the final composition of fermented foods prepared through sourdough fermentation, and recently, sourdough has become an important application to improve nutrition characteristics of bread. Thanks to lactic acid bacteria (LAB) presented in sourdough microflora and metabolites partially produced by yeasts, technological and important nutritional features of the bread improve and an increase in shelf life is achieved. In addition, sourdough bread has a low glycemic index value, high protein digestibility, high mineral and antioxidant content, and improved dietary fiber composition, making it more attractive for human nutrition compared to regular bread. When the sourdough process is applied, the chemical and physical properties of fibers vary according to the degree of fermentation, revealing the physiological importance of dietary fiber and its importance to humans' large intestine microbiota. Therefore, taking these approach frameworks into consideration, this review highlights the benefits of sourdough fermentation in increasing nutrient availability and contributing positively to support human health.

Developing high resistant starch content rice noodles with superior quality: A method using modified rice flour and psyllium fiber

The effects of high-resistant starch (RS) content rice flour, psyllium husk powder (PHP), and psyllium powder (PP) on the edible quality and starch digestibility of rice noodles were investigated in this study. High-RS rice noodles showed lower digestibility but poor edible quality. With the addition of PHP and PP, high-RS rice noodles' cooking and texture quality were improved significantly, especially the breakage rates, cooking losses, and chewiness (P < 0.05). Compared to traditional white rice noodle's estimated glycemic index (eGI) of 86.69, the eGI values for 5PHP-RN and 5PHP-2PP-RN were significantly decreased to 66.74 and 65.77, achieving a medium GI status (P < 0.05). This resulted from the high amylose and lipid content in the modified rice flour and psyllium, leading to increase of starch crystallinity. Besides, based on the analysis of Pearson's correlation, it can be found that PHP rich in insoluble dietary fiber (IDF) could improve high-RS noodle cooking and texture quality better, while PP rich in soluble dietary fiber (SDF) can further reduce the RDS content and its starch digestibility. Therefore, utilizing modified rice flour with an appropriate addition of PHP and PP can be considered an effective strategy for producing superior-quality lower glycemic index rice noodles.

Dietary carbohydrate quality index and incidence of obesity-related cancers in the “Seguimiento Universidad De Navarra” (SUN) prospective cohort

SummaryPurposeThe quality, rather than the quantity, of carbohydrate intake may play a major role in the etiology of obesity-related cancers (ORCs). We assessed the association between a previously defined carbohydrate quality index (CQI) and the risk of developing ORCs in the “Seguimiento Universidad de Navarra” (SUN) cohort.MethodsA total of 18,446 Spanish university graduates [mean age 38 years (SD 12 years), 61% women, mean BMI 23.5 kg/m2 (SD 3.5 kg/m2)], with no personal history of cancer, were followed-up. Baseline CQI was assessed summing quintiles of four previously defined criteria: high dietary fiber intake, low glycemic index (GI), high whole-grain: total-grain carbohydrates ratio and high solid carbohydrates: total carbohydrates ratio. Participants were classified into tertiles of their total CQI. Incident ORCs were confirmed by an oncologist using medical records and by querying the National Death Index blindly to dietary exposures.ResultsDuring a median follow-up of 13.7 years, 269 incident cases of ORC were confirmed. A higher CQI was inversely associated with ORC incidence [multivariable-adjusted hazard ratio (HR) for the upper (T3) versus the lowest tertile (T1) of 0.68 (95% CI: 0.47–0.96), p for trend = 0.047]. Particularly, higher dietary fiber intake was inversely associated with ORC, HRT3 vs. T1=0.57 (95% CI 0.37–0.88 p for trend = 0.013).ConclusionIn this prospective Mediterranean cohort, an inverse association between a better global quality of carbohydrate intake and the risk of ORCs was found. Strategies for cancer prevention should promote a higher quality of carbohydrate intake.

Effect of a diabetes-specific formula in non-diabetic inpatients with stroke: a randomized controlled trial

Background/objectivesIn patients with acute stroke, the presence of hyperglycaemia has been associated with higher morbidity and less neurological recovery. The aim of the study was to evaluate the impact of a diabetes specific enteral nutrition (EN) formula on glycaemia, comorbidities and mortality in patients admitted with a first episode of stroke who received complete EN.MethodsThis was a prospective randomised controlled trial. Patients with acute stroke did not have diagnosis of diabetes mellitus and required nasogastric tube feeding. This study has been registered with code NCT03422900. The patients were randomised into two arms: an isocaloric isoprotein formula (control group (CG), 27 patients) vs a diabetes-specific formula (low glycaemic index carbohydrates, fibre (80% soluble) and higher lipid content) (experimental group (EG), 25 patients). Pre-EN blood glucose, hyperglycaemia during EN treatment, HbA1c, insulin use, oral route recovery, length of stay (LOS) and mortality at 30 days were collected. The complications of enteral nutrition during admission were collected as well.Results52 patients were included, 50% females, with an age of 77.44(11.48) years; 34 (65.4%) had ischaemic stroke, with a Rankin score of 0(0–2), and a National Institute of Health Stroke Scale (NIHSS) of 19 (15–22). In CG, there were more cases of hyperglycaemia on the 5th day post-NE (13(65%) vs7(35%), p < 0.01). CG showed an OR of 7.58(1.49–39.16) (p = 0.02) for the development of hyperglycaemia. There were no differences in LOS between groups (12(8.5) days vs 14(23) days, p = 0.19) or in the death rate (10(37%) vs 10(40%), p = 0.8), although differences were found in terms of oral route recovery (EG: 11(44%) patients vs CG: 5(18.5%) patients, p = 0.04) (OR (EG): 5.53(1.25–24.47); p = 0.02).ConclusionsThe use of a diabetes-specific enteral formula in non-diabetic patients admitted with acute stroke reduced the risk of developing hyperglycaemia and improved the rate of oral route recovery.Registered under ClinicalTrials.gov Identifier no. NCT03422900.

Changes in the Gastrointestinal Microbiota Induced by Proton Pump Inhibitors-A Review of Findings from Experimental Trials.

The use of proton pump inhibitors (PPIs) has increased considerably in many Western countries, and there is concern that numerous conditions and diseases associated with PPI use may be adverse events. The main function of gastric acid is to defend the organism against orally ingested microorganisms, and there is also concern that alterations not only in the gastric microbiome but also the downstream intestinal microbiome may increase the risk of disease or alter the course of preexisting disease. The current study is a systematic review of the available evidence from experimental trials investigating the effects of PPIs on the gastrointestinal microbiota by next-generation sequencing. Thirteen studies were identified. The effects of PPIs were seen on alterations in diversity and richness in some of the studies, while a larger proportion of the studies detected alterations at various taxonomic levels. The general finding was that PPI use caused an increase in bacteria normally found in the oral microbiota in both the upper and lower GI tract. The most consistent taxonomic alterations seemed to be increases in oral flora along the axis Streptococcaceae and Streptococcus at genus level and various Streptococcus spp., as well as Veillonellaceae, Veillonella and Haemophilus.

Moth Bean (Vigna aconitifolia) Starch: Properties, Modifications and Applications—A Review

ABSTRACTMoth bean (Vigna aconitifolia) is considered an underutilized legume but has drawn considerable attention to researchers in recent years owing to its good nutritional value, lower glycemic index, and numerous health benefits. Despite the dietary importance of mung bean as well as starch, the starch extraction processes from moth bean seeds remain inadequately understood. This review discusses recent developments in starch extractability, physico‐chemical and structural characteristics, and different food and non‐food application to utilize moth bean as potential starch source. The starch properties depend mainly on its composition (amylose and amylopectin) and branched chains distribution. Moth bean starch (MBS) exhibited around 15% amylose content and a typical C‐type crystalline structure with granules of diverse sizes and shapes. Different studies exhibited a positive correlation among amylose content and different characteristics of MBS including pasting profile, thermal properties, and its cooking quality. The modification of MBS has been done using some chemical treatments for functionality improvement. MBS possesses good techno‐functional properties that can be exploited for different food product development and non‐food applications. Owing to the promising potential exhibited by native and modified MBS, these can be explored as valuable functional ingredients in various food and non‐food products. Finally, an outlook on potential utilization of MBS in the future is given.

Impact of a Cooking Intervention on the Cooking Skills of Adult Individuals with Type 2 Diabetes Mellitus: A Pilot Study.

To investigate the impact of the Nutrition and Culinary in the Kitchen (NCK) Program on the cooking skills of Brazilian individuals with type 2 diabetes mellitus (T2DM). A randomized controlled intervention study was performed, with intervention and control groups. The intervention group participated in weekly sessions of the NCK Program for six weeks (including two in-person practical cooking and three online cooking workshops). The cooking recipes were adapted by replacing high glycemic index ingredients with low and medium glycemic index alternatives. Of note, the recipes did not contain added sugars or sweeteners, were based on the use of fresh or minimally processed foods, herbs, and spices, and were sensorially tested by individuals with T2DM before use in the intervention. The study outcomes were participant score changes on the seven scales. A validated online instrument was administered to the control and intervention groups at baseline (T1) and post-intervention (T2). Parametric and non-parametric tests were used to assess the differences between the T1 and T2 parameters. Of the 60 individuals enrolled, 44 answered the questionnaire at both times. The findings revealed a 45.37% ± 93.57% increase in Knowledge of Cooking Terms in the intervention group, whereas the control group showed a 3.82% ± 16.17% reduction (p = 0.008). There was an increase in all the other cooking skills and healthy eating scales from T1 to T2 in the intervention group, but the differences were not significant. The development of cooking skills can contribute to increasing culinary knowledge and the availability of time to cook at home. The results contribute to the planning of health actions aimed at individuals with DM2 through culinary interventions and public food and nutrition policies.

D-Arabitol production by a high arabitol-producing yeast, Zygosaccharomyces sp. Gz-5 isolated from miso.

d-Arabitol, an alternative sweetener to sugar, has low calorie content, high sweetness, low glycemic index, and insulin resistance-improving ability. In this study, d-arabitol-producing yeast strains were isolated from various commercial types of miso, and strain Gz-5 was selected among these strains. Phylogenetic tree analysis of the internal transcribed spacer sequence revealed that strain Gz-5 was distinct from Zygosaccharomyces rouxii, a major fermenting yeast of miso. The strain, identified as Zygosaccharomyces sp. Gz-5, grew better than other Z. rouxii in 150g/L NaCl and produced 114g/L d-arabitol from 295g/L glucose in a batch culture for 8 days (0.386g/g-consumed glucose). In a fed-batch culture, the yeast produced 133g/L d-arabitol for 14 days, and the total d-arabitol amount increased by 1.75-fold. These results indicated that Zygosaccharomyces sp. Gz-5, a non-genetically modified strain, has excellent potential for the industrial production of d-arabitol.

Characterization of Polyphenol Composition and Starch and Protein Structure in Brown Rice Flour, Black Rice Flour and Their Mixtures.

The study investigates the structural and chemical properties of brown rice flour (WRF), black rice flour (BRF) and their mixtures in ratios of 25%, 50% and 75% to provide reference information for the gluten-free bakery industry. BRF contains higher concentrations of proteins, lipids, total minerals, crude fiber, total polyphenols, proanthocyanidins and flavonoids than WRF. A higher amylose content in BRF than in WRF resulted in flour mixtures with slower starch digestion and a lower glycemic response depending on the BRF ratio added. Differences in the chemical composition of WRF and BRF led to improved composition of the flour mixtures depending on the BRF ratio. The presence of anthocyanidins and phenolic acids in higher concentrations in the BRF resulted in a red-blue color shift within the flour mixtures. The deconvoluted FTIR spectra showed a higher proportion of α-helixes in the amide I band of BRF proteins, indicating their tighter folding. An analysis of the FTIR spectra revealed a more compact starch structure in BRF than in WRF. By processing reflection spectra, nine optically active compound groups were distinguished in rice flour, the proportion in BRF being 83.02% higher than in WRF. Due to co-pigmentation, the bathochromic shift to higher wavelengths was expressed by the proanthocyanins and phenolic acids associated with the wavelengths 380 nm to 590 nm and at 695 nm. Anthocyanins, protein-tannin complexes, methylated anthocyanins and acylated anthocyanins, associated with wavelengths 619, 644 and 668 nm, exhibited a hypsochromic effect by shifting the wavelengths to lower values. This research represents a first step in the development of rice-based products with increased nutritional value and a lower glycemic index.