Therapeutic Food Research Articles

Nutritional, antioxidant and organoleptic properties of therapeutic-complementary-food formulated from locally available food materials for severe acute malnutrition management

BackgroundThe prevalence of severe acute malnutrition among children (< 5 years) due to low energy-protein density of local complementary foods and poor feeding practices is a great concern in developing countries, Nigeria inclusive. Hence, the aimed of this study was to formulate and evaluate the chemical composition, functional, antioxidant and organoleptic properties of low-cost complementary foods from locally accessible food material using household technologies. Using UNCEF guidelines, three complementary foods were formulated and their nutritional characteristics were compared with local complementary food (100% sorghum) and ready-to-using therapeutic food.ResultsProtein (g/100 g) and energy values (kcal./100 g) of formulated complementary foods varied from 16.16 to 16.93 and 418.08 to 474.13, respectively, and were significantly (p < 0.05) higher than OG (7.72; 378.71) (a 100% sorghum flour), but lower than P0 (539.8) (a read-to-eat therapeutic food). Mineral elements (mg/100 g) in the food samples were K (4175–6350.5), Ca (341.5–949), Fe (23.5–50.5) Zn (28–38.5), P (3855.6–4501), and Na (343.5–950.5), and were significantly lower than in P0, but higher in K, Fe and Zn than for OG. Sodium/Potassium and Calcium/Phosphorous molar ratios of the complementary foods ranged from 0.16 to 0.92 and 0.07 to 0.16 and were lower than P0 (0.64, 0.19) and OG (1.71, 0.2), respectively. Total essential amino acids (g/100 g protein) of the food samples varied from 23.53 to 25.94, and were comparable to OG (28.40) and P0 (32.74). Predicted biological value and essential amino acid index of P2 sample (53.53%, 59.85%) had the highest values, while P1 (46.0%, 52.94%) had the lowest, and these values were comparatively lower than P0 (67.53%, 72.69%), OG (55.91%, 62.03%), and recommended value (> 70%). Functional properties varied from 0.61 to 0.83, 124.2 to 176.2, 102.2 to 257.19, 0 to 1 and 164.7 to 373.3 for bulk density, oil absorption capacity, water absorption capacity, least gelation and swelling capacity, respectively. Antioxidant activity of formulated complementary foods ranged from 2.07 to 3.24%, 8.61 to 9.87 mg/g, 21.6 to 40.95% and 62.42 to 87.0% for DPPH, FRAP, Fe-chelation and OH-free radicals, respectively, and were significantly (p < 0.05) higher than in OG and PO. Sample P1 was significantly (p < 0.05) rated highest in appearance, aroma, taste, texture and overall acceptability above P2 and P3.ConclusionThe formulated complementary foods had enough nutrient and energy values to meet the requirements for infants as recommended for complementary foods and for amelioration of severe acute malnutrition in children. Nutritional and sensory evaluation revealed that addition of full fat milk to the P1 sample significantly improved its nutrient composition and organoleptic quality and contributed to its high acceptance compared to other formulations. Therefore, this complementary food is potentially suitable for use as complementary food and diet to manage severe acute malnutrition in Nigeria and other developing countries. However, there is a need for biological evaluation.

Vegetable microgreens: The gleam of next generation super foods, their genetic enhancement, health benefits and processing approaches

Considering the well-being cognizance of masses, the microgreens have emerged as the potential therapeutic functional foods for improving the overall health by dietary supplementation. Microgreens have delicate texture, distinctive flavors and exceptional volume of various nutrients accounting for higher neutraceutical benefits compared to their mature counterparts. Mounting interest in microgreens owes not only to their nutritional significance but also to their fascinating organoleptic traits. Many factors like rapid shrinkage of the land resources, lifestyle modification, healthy diet habits, the functional importance of food etc. cumulatively have resulted in increased interest in the microscale production of vegetables for the ready-to-eat market. Augmenting the production of secondary metabolites could provide more nutritional benefits, sensory attributes, and resistance to pests while, sharing many characteristics with sprouts, they are not associated with any foodborne illness. Their production by manipulation of agronomic practices like seeds, growing media, and light quality and biofortification with nutrients may result in nutrient-rich produce. These high-value crops typically characterized by short postharvest life and several pre a-harvest treatments can effectively maintain the shelf life of microgreens. Further, several genetic improvement tools can enhance the availability of bioactive compounds with minimum antinutritional factors. In this review, the comparative overview of the nutritional significance of microgreens with sprouts and their mature counterparts has been discussed. Further, the advances or manipulations in production technologies, the involvement of breeding programmes, and efficient post-harvest technologies to promote cost-effective production and future strategies for maintaining the shelf life and quality of microgreens have been argued.

Expert opinion on the impact of nutritional support on functional recovery and prognosis in patients with stroke and its complications

Clinical nutrition (nutritive, nutritional support) using food products of dietary therapeutic and dietary preventive nutrition is currently considered as an integral part of the treatment of patients who are unable to meet the body's needs for nutrients and energy in the usual way. The evaluation of the impact of nutritional support on the functional recovery and prognosis of patients with acute cerebrovascular accident and the results of studies in 20202021 on the use of specialized therapeutic food products was devoted to the symposium of the Nutricia company "Therapeutic nutrition is one of the most important links in the treatment of stroke and its complications", which was held within the framework of the XVIII annual interdisciplinary conference "Wein Readings 2022" with the participation of leading experts in the field of nutrition, neurology and palliative care. According to current research, among the main effects of the use of specialized therapeutic food products, there was an improvement in functional recovery, an increase in rehabilitation potential, an improvement in the quality of life of patients, as well as a decrease in the severity of infectious complications and economic feasibility for the healthcare system.

Antioxidant and anti-inflammatory activities of durian (Durio zibethinus Murr.) pulp, seed and peel flour.

The unripe pulp, inner peel and seed of durian were used in this study. These are generally not considered edible and must be disposed of as waste. However, they are good sources of bioactive compounds. Flour extracts from the unripe pulp, inner peel, and seed of two durian (Durio zibethinus Murr.) varieties, namely, Monthong and Chanee, were analyzed chemically to determine their total phenolic content (TPC), antioxidant, and anti-inflammatory capacities. Chanee pulp (CPu) contained a higher TPC (5285.37 ± 517.65 mg GAE/g) than Monthong pulp (MPu), Monthong peel (MP), Monthong seed (MS), Chanee peel (CP) and Chanee seed (CS) (p = 0.0027, 0.0042, 0.0229, 0.0069 and 0.36), respectively. The antioxidant activity of each durian extract was determined against ABTS, nitric oxide, superoxide, hydroxyl, and metal ions. The results indicated that the pulp, inner peel and seed of these durian varieties had antioxidant capacities. Murine Raw 264.7 macrophages were used to determine the cytotoxicity of the flour extracts. The extract of CS flour had the lowest cytotoxicity followed by MP, CPu, CP, MPu and MS (p = 0.5926, 0.44, 0.3191, 0.1471 and 0.0014), respectively. The anti-inflammatory activity was tested by anti-nitric oxide (NO) production in lipopolysaccharide (LPS) stimulated cells by co-treating the Raw 264.7 cells with each durian flour extract and LPS. The extract of MP flour had the lowest IC50 against NO production, indicating the highest anti-NO production activity followed by CS, CPu, MPu, CP and MS (p = 0.7473, 0.0104, < 0.0001, 0.0002 and < 0.0001, respectively). The information obtained in this study is useful for researchers to explore more durian varieties in Southeast Asia to find bioactive compounds that might be novel nutraceuticals for antioxidant, anti-inflammation and therapeutic functional food.

Acceptability of Locally Produced Ready to Use Therapeutic Food (RUTF) in Malnourished Children: A Randomized, Double-Blind, Crossover Study.

To compare the acceptability of a locally produced ready-to-use therapeutic food (L-RUTF) with the standard ready-to-use therapeutic food (S-RUTF). It was a single-center, randomized, double-blind, two-way crossover study. The participants were 6-59-mo-old children residing in an urban slum, with weight-for-height z score (WHZ) < -2SD. The study had two intervention periods of feeding with two types of RUTF- L-RUTF and S-RUTF-for a period of 24h, separated by a wash-out period of 7 d. The outcome measures were the acceptability measured as consumption of more than two-thirds of the total calories offered (150kcal/kg/24h) and the degree of liking of the food measured by organoleptic evaluation. Both types of RUTF did not qualify as acceptable. L-RUTF was preferred over S-RUTF in organoleptic evaluation. The study suggests that RUTF products are not suitable for use as a single therapeutic food during nutrition rehabilitation of children with acute malnutrition. The study was registered in the clinical registry of India; Reg. No: CTRI/2018/04/012967.

Sargahydroquinoic acid isolated from Sargassum serratifolium as inhibitor of cellular basophils activation and passive cutaneous anaphylaxis in mice

Basophils and mast cells are characteristic effector cells in allergic reactions. Sargahydorquinoic acid (SHQA), a compound isolated from Sargassum serratifolium (marine alga), possesses various biochemical properties, including potent antioxidant activities. The objective of the present study was to investigate inhibitory effects of SHQA on the activation of human basophilic KU812F cells induced by phorbol myristate acetate and A23187 (PMACI), a calcium ionophore. Furthermore, we confirmed the inhibitory effects of SHQA on the activation of rat basophilic leukemia (RBL)–2H3 cells induced by compound 48/80 (com 48/80), bone marrow-derived mast cells (BMCMCs) induced by anti-dinitrophenyl(DNP)-immunoglobulin E (IgE)/DNP-bovine serum albumin (BSA), DNP/IgE and on the reaction of passive cutaneous anaphylaxis (PCA) mediated by IgE. SHQA reduced PMACI-induced intracellular reactive oxygen species (ROS) and calcium levels. Western blot analysis revealed that SHQA downregulated the activation of ERK, p38, and NF-κB in a dose-dependent manner. Moreover, SHQA suppressed the production and gene expression of various cytokines, including interleukin (IL)-1 β, IL-4, IL-6, and IL-8 in PMACI-induced KU812F cells and IL-4 and tumor necrosis factor (TNF)- α in com 48/80-induced RBL-2H3 cells. It also determined the inhibition of PMACI, com 48/80- and IgE/DNP-induced degranulation by reducing the release of β -hexosaminidase. Furthermore, it attenuated the IgE/DNP-induced PCA reaction in the ears of BALB/c mice. These results suggest that SHQA isolated from S. serratifolium is a potential therapeutic functional food material for inhibiting effector cell activation in allergic reactions and anaphylaxis in animal model.

Extraction, structure and pharmacological effects of the polysaccharides from Cordyceps sinensis: A review

Cordyceps sinensis (the new species name is Ophiocordyceps sinensis) is a precious Chinese medicinal material. The polysaccharides are one of the important biologically active components of C. sinensis and have attracted more and more attention from scholars. The purpose of the review is to systematically review relevant studies on the extraction, structure, and pharmacological effects of C. sinensis polysaccharides to support their further application as therapeutic agents and functional foods. The results show that these C. sinensis polysaccharides have different structure, which may be closely related to their pharmacological activities. C. sinensis polysaccharides have various pharmacological effects including anti-oxidant, anti-inflammatory, immunomodulatory and prebiotics effect. Moreover, C. sinensis polysaccharides can produce anti-cancer, anti-diabetes and anti-atherosclerosis effects, and have protective effects on the liver, intestine and kidney. In short, C. sinensis polysaccharides show potential medicinal value, and are expected to be used in the treatment of many diseases.

Therapeutic Food Development from Maize Grains, Pulses, and Cooking Banana Fruits for the Prevention of Severe Acute Malnutrition.

In children under five years of age, severe acute malnutrition is a complex and challenging problem, especially those living in poor communities. Therefore, this study aimed to formulate ready-to-use therapeutic foods from affordable, locally available cereals, pulses, and banana fruits to overcome the problem of severe acute malnutrition. Maize grains, pulses (soybeans), and cooking banana fruits were ingredients used in formulations of ready-to-use therapeutic foods (RUTF). A completely randomized design was done with two replicates. Data were analyzed using analysis of variance. A significant difference existed in the appearance and consistency for RUTF1, RUTF2, and RUTF3 samples (P < 0.05). The study findings revealed that the moisture content varied from 6.7 to 13.4%, energy from 513.2 to 642.41 kcal/100 g, protein from 13.9 to 19.34%%, and crude fat from 24.12 to 35.54%. The calcium content ranged from 225 to 302 g/100 mg, iron from 10.34 to 12.26 g/100 mg, and zinc from 10 to 20 g/100 mg. In this study, the phytate content varied from 314.74 to 369.3 μg/g and crude tannin, from 101.36 to 153.25 μg/g. This study concluded that the ingredients used in the RUTF1, RUTF2, and RUTF3 formulations met the standard ready-to-use therapeutic foods. Therefore, it is important to prescribe ready-to-use dietary supplements made from inexpensive, locally available, and culturally acceptable foods to prevent severe acute malnutrition in infants.

Simplifying and optimising management of acute malnutrition in children aged 6 to 59 months: study protocol for a 3 arms community-based individually randomised controlled trial in decentralised Niger

BackgroundSimplified approaches of acute malnutrition (AM) treatment have been conducted over the past 5 years intending to unify processes and increase coverage among children aged 6 to 59 months without medical complication. The Optimsing treatment for Acute Malnutrition (OptiMA) and the Combined Protocol for Acute Malnutrition Study (ComPAS) are mid-upper arm circumference (MUAC)-based approaches treating children with MUAC < 125 mm or oedema with one sole product—ready-to-use therapeutic food—at a gradually tapered doses. This trial aims to compare the OptiMA and ComPAS strategies to the standard nutritional protocol of Niger assessed by a favourable outcome in the treatment of uncomplicated AM at 6 months post-randomisation and in terms of recovery rate after treatment of uncomplicated SAM (WHZ < − 3 or MUAC < 115mm or oedema) and among the most vulnerable children (MUAC < 115mm or oedema).MethodsA non-inferiority individually randomised controlled clinical trial was conducted at the primary health centres level and in the community in the Zinder region in Niger in March 2021. Participants are children aged 6–59 months attending outpatient health centres with MUAC < 125mm or oedema without medical complications. All participants are followed for 6 months. Simplified strategies propose a gradual reduction of RUTF according to MUAC and weight in OptiMA and MUAC only in ComPAS. Favourable outcome is compositely defined at 6 months post-inclusion as being alive, not acutely malnourished by the definition applied at inclusion and without any additional episode of AM throughout the 6-month observation period. Recovery is defined throughout the 6 months post-randomisation by a minimum of 4-week duration of treatment, an axillary temperature < 37.5°C, an absence of bipedal oedema and a MUAC ≥ 125 mm for two consecutive weeks. The sample size calculation required 567 children per arm for the main objective, 295 and 384 children per arm for the secondary objectives among SAM and MUAC < 115 mm children, respectively. Per-protocol and intention-to-treat analyses will be conducted for each outcome.DiscussionThis trial is intending to generate much-needed evidence on various simplified and optimised AM treatment approaches and to participate in reaching a consensus on such nutrition protocols.Trial registrationClinicalTrials.govNCT04698070. Registered on January 6, 2021

Evaluation of Dose-Dependent Obesity and Diabetes-Related Complications of Water Chestnut (Fruit of Trapa japonica) Extracts in Type II Obese Diabetic Mice Induced by 45% Kcal High-Fat Diet.

Background and Objectives: The currently used pharmacological agents for metabolic disorders such as type II diabetes have several limitations and adverse effects; thus, there is a need for alternative therapeutic drugs and health functional foods. Materials and Methods: This study investigated the pharmacological effects of water chestnut (fruit of Trapa japonica) extracts (WC: 50–200 mg/kg) for type II diabetes using a 45% Kcal high-fat diet (HFD)-fed type II obese diabetic mice model for a period of 84 days, and the effects were compared to those of metformin (250 mg/kg). Results: Increases in body weight, serum biochemical indices such as triglycerides, low-density lipoprotein, and blood urea nitrogen, increases in antioxidant defense system enzymes such as catalase, superoxide dismutase, and glutathione, and mRNA expressions (such as AMPKα1 and AMPKα2) in the liver tissue and mRNA expressions (such as AMPKα2 mRNA, leptin, and C/EBPα) in the adipose tissue were observed in the HFD control group. The WC (50 mg/kg)-administered group showed no significant improvements in diabetic complications. However, HFD-induced obesity and diabetes-related complications such as hyperlipidemia, diabetic nephropathy, nonalcoholic fatty liver disease (NAFLD), oxidative stress, activity of antioxidant defense systems, and gene expressions were significantly and dose-dependently inhibited and/or normalized by oral administration of WC (100 mg/kg and 200 mg/kg), particularly at a dose of 100 mg/kg. Conclusions: The results of this study suggest that WC at an appropriate dose could be used to develop an effective therapeutic drug or functional food for type II diabetes and various associated complications, including NAFLD.

UHPLC-MS/MS-BASED PLASMA LIPIDOMICS REVEAL ALTERATIONS ASSOCIATED WITH EXCLUSIVE ENTERAL NUTRITION TREATMENT IN ADULT PATIENTS WITH ACTIVE CROHN’S DISEASE

Abstract BACKGROUND Exclusive enteral nutrition (EEN) is an effective treatment for active Crohn’s disease (CD), although the mechanisms is unclear. Lipid metabolism and signaling have been suggested to play an important role in the pathophysiology of the disease, but their relationship with EEN therapy has not been reported. Hence, we assessed plasma lipid profiles of adult patients with active CD before and after EEN and compared them to those of healthy controls. METHODS Adult patients with active CD (n=11) who received EEN with an amino acid-based enteral nutrition formula for 12 weeks and age- and sex-matched healthy controls (n=17) were recruited. Plasma lipid profiles of 869 lipid species were measured before and after EEN in both groups using ultrahigh performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). The CD activity index (CDAI), high-sensitivity C-reactive protein (hs-CRP) level, and nutrition-associated indices were evaluated. CDAI &amp;lt;150 and a Simple Endoscopic Score for CD (SES-CD) ≤2 indicated clinical remission and mucosal healing (MH), respectively. RESULTS After 12 weeks of EEN, 81.8% (9 of 11) patients achieved remission with a significant decrease in the CDAI (P&amp;lt;0.001) and hs-CRP levels (P&amp;lt;0.001). Ten patients had a SES-CD score of &amp;gt;2 before EEN, which declined after EEN (P=0.009), with four patients achieving MH. Before EEN initiation, 80 lipid species/17 lipid classes were significantly different between patients with CD and healthy controls. After EEN initiation, 103 lipid species/11 lipid classes were significantly different between patients with CD and healthy controls. Thirty-eight significantly different lipid species from eight lipid classes—cholesterolester (n=1), lysophosphatidylcholine (n=3), monogalactosyldiacylglycerol (n=1), phosphatidylcholine (n=18), phosphatidylethanolamine (n=3), phosphatidylinositol (n=4), phosphatidylserine (n=1), and phosphatidylglycerol (n=7)—were identified in patients with CD before and after EEN. Among these lipid classes, the levels of monogalactosyldiacylglycerol, phosphatidylinositol, and phosphatidylcholine decrased significantly and that of phosphatidylglycerol increased significantly before EEN in patients with CD compared to those in healthy controls (P&amp;lt;0.05). These lipids returned to similar levels of healthy controls after EEN (P&amp;gt;0.05). Lipid classes and species were significantly associated with clinical indices of CDAI, hs-CRP, and MH. Pathway analysis suggested that arachidonic acid, glycerophospholipid, linoleate, and phosphatidylinositol phosphate metabolisms were related to the mechanism of EEN treatment. CONCLUSION EEN leads to the alterations in multiple lipid classes and species, in keeping with improvement in clinical response. However, further studies are needed to confirm their precise roles.

Evaluating the potential for utilising migratory locust powder (Locusta migratoria) as an alternative protein source in peanut-based ready-to-use therapeutic foods.

This study aimed at exploring the possibility of substituting powdered milk (PM) with migratory locust powder (MLP) as a cheap and sustainable alternative protein source in peanut-based ready-to-use therapeutic foods used in treatment of malnutrition. The migratory locust is a wide spread and underutilised high protein edible insect. Peanut-based ready-to-use therapeutic foods (RUTFs) were formulated according to the MSF/UNICEF 2013 nutritional standards. Milk powder was substituted with MLP at 5-30% levels. RUTF containing 30% milk powder was used as the control. Nutritional, antioxidant and antinutrients composition of the insect-enriched RUTFs were compared with RUTF containing milk powder only and a standard. The protein content of the insect-enriched RUTFs ranged from 19.58-26.38% exceeding the MSF/UNICEF minimum standard for protein. RUTF with 10% PM and 20% MLP had the highest (p < 0.05) mineral contents. All formulations had more thiamine (vitamin B1) than the recommended level of 0.5 mg/100 g. Niacin (Vitamin B3) was the most abundant vitamin in the formulations with considerable amounts of vitamin D and E. All MLP-enriched RUTFs met the FAO 2011 standard requirements for amino acids for children aged six months to three years. Therapeutic food with 30% MLP had the highest radical scavenging ability against DPPH, and iron chelating activity. Levels of phytate and tannin were below the tolerable limits. Therefore, MLP can be used as a low-cost substitute for milk powder in producing ready-to-use therapeutic foods.

Predictors of the amount of intake of Ready-To-Use-Therapeutic foods among children in outpatient therapeutic programs in Nairobi, Kenya.

Ready‐to‐use Therapeutic Food (RUTF) therapy is a standard protocol for treating children with severe acute malnutrition (SAM) admitted in Out‐Patient Therapeutic Programmes (OTP). The amount of RUTF to be consumed by a child is based on weight (200 kcal/kg body weight/day) as stipulated in the Kenya Integrated Management of Acute Malnutrition (IMAM) protocol for timely weight gain. There is limited information on the determinants of consumption of the correct amount of RUTF. This study sought to fill this gap by establishing the associations between the caregivers' and the child's characteristics and the amount of RUTF the child ate within a 24‐h recall period. We used a cross‐sectional study design and interviewed 200 caregivers of children 6–23 months of age admitted in four OTP centers in Nairobi Kenya. We used a researcher‐administered questionnaire to collect information from the caregivers. Seventy‐three percent of the children ate the recommended amount of RUTF. A smaller proportion (54.4%) of younger children (6–11 months of age) ate the recommended amount of RUTF compared to older children (12–17 months old and 18–23 months old at 89.1% and 82.8%, respectively). The predictors of consumption of the correct amount of RUTF were child's birth order—firstborn (AOR 29.92; 95% CI: 5.67–157.93) and children's age; 12–17 months old (AOR 5.19; 95% CI: 2.18–12.36) and 18–23 months (AOR 6.19 95% CI: 2.62), indicating that firstborn and older children were more likely to consume the correct amounts of RUTF. Caregivers' knowledge and correct practices in feeding a child with RUTF also predicted the consumption of the correct amount of RUTF. In conclusion, maternal and child characteristics are determinants of the consumption of the correct amount of RUTF by children in OTP.

Serum Amyloid A3 Promoter-Driven Luciferase Activity Enables Visualization of Diabetic Kidney Disease.

The early detection of diabetic nephropathy (DN) in mice is necessary for the development of drugs and functional foods. The purpose of this study was to identify genes that are significantly upregulated in the early stage of DN progression and develop a novel model to non-invasively monitor disease progression within living animals using in vivo imaging technology. Streptozotocin (STZ) treatment has been widely used as a DN model; however, it also exhibits direct cytotoxicity to the kidneys. As it is important to distinguish between DN-related and STZ-induced nephropathy, in this study, we compared renal responses induced by the diabetic milieu with two types of STZ models: multiple low-dose STZ injections with a high-fat diet and two moderate-dose STZ injections to induce DN. We found 221 genes whose expression was significantly altered during DN development in both models and identified serum amyloid A3 (Saa3) as a candidate gene. Next, we applied the Saa3 promoter-driven luciferase reporter (Saa3-promoter luc mice) to these two STZ models and performed in vivo bioluminescent imaging to monitor the progression of renal pathology. In this study, to further exclude the possibility that the in vivo bioluminescence signal is related to renal cytotoxicity by STZ treatment, we injected insulin into Saa3-promoter luc mice and showed that insulin treatment could downregulate renal inflammatory responses with a decreased signal intensity of in vivo bioluminescence imaging. These results strongly suggest that Saa3 promoter activity is a potent non-invasive indicator that can be used to monitor DN progression and explore therapeutic agents and functional foods.

Comparing Azithromycin to Amoxicillin in the Management of Uncomplicated Severe Acute Malnutrition in Burkina Faso: A Pilot Randomized Trial.

Azithromycin is a promising alternative to amoxicillin in the management of uncomplicated severe acute malnutrition (SAM) as it can be administered as a single dose and has efficacy against several pathogens causing infectious disease and mortality in children under 5. In this pilot trial, we aimed to establish the feasibility of a larger randomized controlled trial and provide preliminary evidence comparing the effect of azithromycin to amoxicillin on weight gain in children with uncomplicated SAM. We enrolled children 6-59 months old with uncomplicated SAM at six healthcare centers in Burkina Faso. Participants were randomized to a single dose of azithromycin or a 7-day course of amoxicillin and followed weekly until nutritional recovery and again at 8 weeks. Apart from antibiotics, participants received standard of care, which includes ready-to-use therapeutic food. Primary feasibility outcomes included enrollment potential, refusals, and loss to follow-up. The primary clinical outcome was weight gain (g/kg/day) over 8 weeks. Outcome assessors were masked. Between June and October 2020, 312 children were screened, 301 were enrolled with zero refusals, and 282 (93.6%) completed the 8-week visit. Average weight gain was 2.5 g/kg/day (standard deviation [SD] 2.0) in the azithromycin group and 2.6 (SD 1.7) in the amoxicillin group (mean difference -0.1, 95% CI -0.5 to 0.3, P = 0.63). Fewer adverse events were reported in the azithromycin group (risk ratio 0.50, 95% CI 0.31-0.82, P = 0.006). With strong enrollment and follow-up, a fully powered trial in this setting is feasible.

Antidiabetic properties of finger millet (Eleusine coracana (L.) Gaertn.) varieties cultivated in Sri Lanka

IntroductionFinger millet is considered as a therapeutic food for diabetes mellitus. However, there is a lack of scientific evidence on the antidiabetic potential of the finger millet varieties which are commonly cultivated in Sri Lanka. Materials and methodsThis study was focused on determining anti-α-amylase, anti-α-glucosidase, antiglycation, glycation reversing and radical scavenging activities and total phenolic and flavonoid contents of Ravi, Rawana and Oshadha finger millet varieties, using ethanolic and methanolic extracts of whole grain flours, in view of their antidiabetic potential. Results and discussionThe findings revealed anti-α-amylase, anti-α-glucosidase, antiglycation and glycation reversing activities of Ravi, Rawana and Oshadha finger millet varieties while indicating their potential of decreasing the postprandial hyperglycemia and preventing advanced glycation end products-mediated diabetic complications. Ethanolic extract of Oshadha indicated the highest anti-α-amylase activity (IC50 value: 1.62 ± 0.04 mg/mL), methanolic extract of Oshadha indicated the highest antiglycation (IC50 value: 79.42 ± 4.46 µg/mL) and glycation reversing (EC50 value: 411.76 ± 5.91 µg/mL) activities and methanolic extract of Ravi indicated the highest anti-α-glucosidase activity (IC50 value: 47.96 ± 0.79 µg/mL). Anti-α-amylase and anti-α-glucosidase activities of the finger millet varieties can be attributed to their phenolic and flavonoids contents and antiglycation and glycation reversing activities can be attributed to the radical scavenging potential of their phenolic compounds including flavonoids. ConclusionThese findings scientifically proved the efficacy of using Ravi, Rawana and Oshadha varieties in prevention and dietary management of diabetes mellitus and its complications and reinforced the traditional recommendation of finger millet-based foods for diabetic patients.

Assessment of the prebiotic potential and bioactive components of common edible mushrooms in India and formulation of synbiotic microcapsules

Pleurotus spp. are listed among “mushroom nutraceutical” accredited to their nutritional and medicinal attributes. In this present study, five different common edible mushrooms i.e., Pleurotus (P.) ostreatus, Pleurotus (P.) florida, Pleurotus (P.) sajor-caju, Agaricus (A.) bisporus and Lentinus (L.) edodes were screened for the highest prebiotic content. Their beneficial bioactive (eritadenine, flavonoid and polyphenol) and prebiotic (β-glucan and inulin) components were quantified by different biochemical and High Performance Liquid Chromatography (HPLC). The mushroom extracts were then evaluated for their compatibility with the potential probiotic lactic acid bacteria (Enterococcus (E.) faecium and Lactiplantibacillus plantarum) to formulate synbiotic microcapsules. P. florida extract showed highest β-glucan and very high inulin content so it could act as a great source of prebiotics. Besides, the extract from P. florida contained the highest concentration of eritadenine and was also found to be most compatible with E. faecium, confirmed by its high prebiotic activity score in comparison with the commercial prebiotic i.e., inulin. Furthermore, the probiotics selected for the formulations of the microcapsules have high potential for therapeutic applications, antihypertensive and hypocholestromeic activity. Therefore, the formulated microcapsules as such or when incorporated into food matrices (therapeutic food) might be effective in decreasing blood pressure and blood cholesterol.

Ready-to-Use Therapeutic Food (RUTF) Formulations with Functional Food and Nutrient Density for the Treatment of Malnutrition in Crisis.

Background:Ready-to-use therapeutic food (RUTF) spread has been highly effective in the treatment of malnutrition in those affected by disasters since it does not require preparation and baking and has a long shelf life and sufficient energy to improve growth and weight loss. Such features may be crucial during crises such as wars and natural disasters. The present study aimed to design a high-energy and nutrient-dense RUTF formulation.Methods:Soybean flour and milk protein concentrate were used as protein sources, corn flour, and sugar were employed as carbohydrate sources, cacao butter substitute was used as the lipid source, and vitamin/mineral, beta-alanine, arginine, Nigella sativa, and sesame seeds were used as a functional food. The study was performed in accordance with the guidelines of the Institute of Medicine (IOM) and criteria for food products.Results:To design the formulation, we used carbohydrates (45% of total energy), protein (13% of total energy), fat (42% of total energy), vitamins, minerals, beta-alanine, and arginine, and 100 grams of the diet was considered to release 525 kilocalories of energy. The experimental results of food safety at the determined intervals (at the beginning and 45 and 90 days after the production) showed acceptable values.Conclusions:Since nutritional requirements are among essential human needs (especially in the management of malnutrition in crisis), it is of utmost importance to prepare RUTF products in order to meet all human nutritional needs by facilitating the easy use of these products, particularly for the prevention of malnutrition and diseases.

Nutritional quality of Ready-to-Use Therapeutic Foods: focus on lipid composition and vitamin content

Severe Acute Malnutrition (SAM) is still a public health issue in many low-income and middle-income countries. Its management has changed with the development of Ready-to-Use Therapeutic Foods (RUTF) that are energy-dense, lipid-based, micronutrient-enriched foods. The purpose of the present study was to define some aspects of the nutritional profile (in particular, lipid content, fatty acids profile, lipophilic vitamin content), oxidative status, and mycotoxin content of three RUTF products (of which two manufactured in Asia and one in Europe), at different time points during their storage. All RUTF displayed good lipid stability, with peroxide values &lt; 10 meqO2/kg lipids, acidity index &lt; 0.6 g/100 g lipids, and very low amounts of secondary oxidation volatile compounds. Only the one produced in Europe complied with the international recommendations on vitamin A and E contents. Lipid content ranged from 28.7 ± 0.5 to 41.2 ± 2.4 g/100 g. Oleic acid, palmitic acid, and linoleic acid (47.2 ± 7.4%, 26.8 ± 2.1%, and 12.4 ± 3.9% of total lipids, respectively) were the main fatty acids. Only one of the samples made in Asia exceeded the regulatory limit of mycotoxins. The RUTF lipid phase was rather stable at ambient temperature from 9 to 12 months, and appropriate packaging may have contributed to a major stability.

Optimising the Dosage of Ready-to-Use Therapeutic Food in Children with Uncomplicated Severe Acute Malnutrition: A Non-Inferiority Randomised Controlled Trial in the Democratic Republic of Congo

Optimising the Dosage of Ready-to-Use Therapeutic Food in Children with Uncomplicated Severe Acute Malnutrition: A Non-Inferiority Randomised Controlled Trial in the Democratic Republic of Congo