Sugar-free Candies Research Articles

Xerostomia in patients with heart failure - prevalence, intensity and reported strategies of symptom reduction

Abstract Background Xerostomia is a common symptom in patients with chronic heart failure (CHF), with a reported prevalence rate of up to 62%. It is defined as the perception of oral dryness, along with swallowing difficulties, oral burning, and altered taste. Despite being a widespread symptom, xerostomia is insufficiently studied CHF patients from german-speaking countries. Purpose The purpose of this study was to assess the prevalence, perceived intensity, and severity of xerostomia in German CHF patients. Additionally, patients´ reported strategies of symptom reduction were investigated. Methods Multi-center, cross-sectional study. Patients with a confirmed diagnosis of heart failure were recruited during visits to heart failure outpatient clinics or while hospitalized for any reason. If they consented to participate, they received a self-administered questionnaire containing questions about xerostomia, perceived distress and severity of xerostomia, and patients' measures to reduce xerostomia. Disease-related data were extracted from the patients' medical records. Perceived intensity of mouth dryness was measured using a visual analog scale (VAS) with 0 for "little dry" and 100 for "maximum imaginable dryness." To assess the severity of xerostomia, the short version of the xerostomia inventory (XI) was used with 5 items inquiring about the frequency of specific xerostomia symptoms. Sumscores of the XI ranged from 5 to 15, with higher scores indicating a higher severity of xerostomia. Measures to reduce dry mouth could be stated in patients' own words. Results Overall, 371 patients with a mean age of 62.4 (± 14.9) took part in this study. Most patients (230; 62%) had CHF with reduced ejection fraction. The main aetiology for heart failure was ischemic heart disease (118; 31.8%), followed by dilated cardiomyopathy (116; 31.3%). Out of 371 patients, 361 answered the question of whether they had suffered from dry mouth in the last three days. The prevalence rate of xerostomia was 65% (n=234) (95% CI: 60%; 70%). Perceived intensity of mouth dryness, using VAS, was 55.5 (± 22.3). The median severity score of the XI was 9 (Interquartile-Range: 8;11). Patients mostly experienced dry mouth in the morning and at night. The most frequently mentioned measures against dry mouth were drinking something (water, juice, coffee, tea, buttermilk), rinsing or moistening the mouth, sucking candies (sugar-free candies, peppermint, lemon, menthol), eating fruits, and using chewing gums. Conclusion Xerostomia is a widespread symptom in German heart failure patients, affecting more than half of the patients included in the study. The intensity and degree of severity appear to be in a medium range. CHF patients used various interventions to relieve the burden of xerostomia. These measures should be further investigated for their effectiveness.

Development of an Antioxidant-Rich Sugar-Free Plantain Candy and Assessment of Its Shelf Life in a Flexible Laminate.

Candy is a popular confection worldwide, and it would be beneficial to society if it were converted into a source of antioxidant molecules to eliminate its adverse health effects. The amount of antioxidants available even in fruit candies is questionable due to the high thermal processing losses they undergo and the presence of various food additives. Plantains (Musa paradisiaca) are less known as good sources of biotherapeutic antioxidants, namely l-tryptophan, serotonin and melatonin, and consumption of this highly nutritious fruit is limited to underdeveloped and developing countries. The objectives of this study are: to develop a functional antioxidant-rich sugar-free plantain-based candy with valuable contents of the mentioned biomolecules in synergy; and to ensure its extended shelf life without compromising its physicochemical properties and functionality by wrapping it with a suitable packaging laminate. To accomplish the first objective, lyophilized plantain powder, sorbitol and mannitol were used as base materials with minimal additives under minimal processing conditions to reduce processing loss. Sensory, proximate, physicochemical and phytochemical properties, including the antioxidant synergy among the mentioned biomolecules of the developed candies were evaluated. For the second objective, the candies were enclosed in two different flexible packaging laminates and the optimal packaging was determined based on the microbiological safety and sensory appeal of the wrapped candies. Subsequently, the above-mentioned properties of the packaged (in the most suitable laminate) candies were evaluated at regular time intervals during storage for assessment of their shelf life. The candy had a characteristic flavour of plantain, uniform dark brown colour, rich mouthfeel, pleasant aroma, moderately hard texture and moderate sweetness, along with high antioxidant activity and considerable content of l-tryptophan, serotonin and melatonin (present as a synergistic consortium). During storage of the packaged candy under ambient conditions, it remained microbiologically safe for up to 56 days, and also maintained sensory attributes, antioxidant activity and synergy compared to the control candy. This newly developed semi-hard sugar-free candy with high antioxidant content, containing three important antioxidants, namely l-tryptophan, serotonin and melatonin, could be a good source of biotherapeutic molecules and a substitute for commercial candies consumed globally.

Hard-Candy Consumption Does Not Have an Effect on Volume and pH of Gastric Content in Patients Undergoing Elective Gastrointestinal Endoscopic Procedures: A Randomized Controlled Trial.

This study aimed to determine the effect of hard candies on gastric content volume and pH in patients undergoing elective esophagogastroduodenoscopy and colonoscopy. Additionally, the study evaluated the difficulty of the procedure, complications, and satisfaction levels of the endoscopist and patient. A randomized controlled study equally recruited 108 outpatients to candy and control groups. The patients in the candy group could consume sugar-free candies within 2 hours before anesthesia, while the controls remained fasted. The endoscopic procedure began under topical pharyngeal anesthesia and intravenous sedation. A blinded endoscopist suctioned the gastric volume through an endoscope. A blinded anesthesia provider tested the gastric pH with a pH meter. The primary outcome variables were gastric volume and pH. The secondary outcome variables were complications, the difficulty of the procedure, and endoscopist and patient satisfaction. The characteristics of both patient groups were comparable. The mean gastric volume of the candy group (0.43 [0.27-0.67] mL/kg) was not significantly different from that of the control group (0.32 [0.19-0.55] mL/kg). The gastric pH of both groups was similar: 1.40 (1.10-1.70) for the candy group and 1.40 (1.20-1.90) for the control group. The procedure-difficulty score of the candy group was higher than that of the control group. The satisfaction scores rated by the endoscopist and the patients in both groups were comparable. In addition, most endoscopists and patients in the candy and control groups reported being "very satisfied". No complications were observed in either group. Hard candies did not affect gastric volume or pH. Elective gastrointestinal endoscopic procedures in adult patients who preoperatively consume candies could proceed to prevent delays and disruption of workflows.

What are dentists seeing in older adults?

What are dentists seeing in older adults?

Hyposalivation and Xerostomia and Burning Mouth Syndrome: Medical Management.

In this chapter, the authors review the benefits of saliva and the destructive consequences of its loss. It is hoped that this will help their colleagues identify and treat patients before development of symptoms. Xerostomia is the subjective complaint of dry mouth or sensation of oral dryness. Hyposalivation is the actual decrease in measured salivary outflow. The authors discuss a compiled list of highly cited medications commonly used today that are linked with xerostomia and hyposalivation. There are numerous treatment modalities that are present, such as saliva substitutes, mouth rinses, sugar-free candy, and pilocarpine among others.

Formulation Optimization of Sucrose-Free Hard Candy Fortified with Cudrania tricuspidata Extract.

The aim of the study is to define the optimal formulation of sucrose-free hard candy using D-optimal mixture design as the base for the incorporation of Cudrania tricupidata fruit. Hard candy was produced using three different polyols: isomalt, maltitol syrup, and xylitol. This study examined the effects of polyol mixtures as sucrose and corn syrup substitutes on physicochemical (moisture, color, soluble solid (SSC)), hardness, and sensory features of hard candies. These three polyols had notable effects on quality characteristics in addition to their effects on L* value. Xylitol had an undesirable effect on moisture content and hardness, resulting in decreased texture acceptability, but improved color and clarity. Given the results of our experiments and optimization of variables, we determined that 90.21% isomalt, 8.63% maltitol syrup, and 1.16% xylitol produced a sugar-free candy with high desirability (0.894).

Physicochemical properties and glucose tolerance of low‐calorie cookies containing palatinose

This study was conducted to investigate the physicochemical properties and glucose tolerance of cookies made with palatinose as an alternative sweetener to sucrose. The analysis of texture properties showed that the hardness (8.63 kg-force) of the control (sucrose) was significantly different (p < .05) from that of the cookies containing palatinose (5.34–8.51 kg-force). The pH of the cookies showed an increasing trend with an increase in the palatinose replacement ratio. Cookies containing palatinose had significantly lower L values and higher values than that of cookies made with 100% sucrose. The overall acceptance of the cookies was highest (4.07) for the samples containing 80% sucrose/20% palatinose. Moreover, the oral glucose tolerance test and area under the curve of cookies containing palatinose showed relatively lower values compared to those of the control. The discrimination of sweetness sensory in the same mixing ratios of sucrose and palatinose did not significantly differ (Table 3). Practical applications Palatinose, a commercial isomaltulose, is made from by enzymatic rearrangement (isomerization) of sucrose beet sugar. Its physical properties closely resemble those of sucrose, making it easy to use in exiting recipes and processes. Isomaltulose is hydrogenated to produce isomalt, a minimally digestible carbohydrate that is used as a sugar replacer, for example in sugar-free candies and confectioneries. Like sucrose, isomaltulose can be digested to glucose and fructose. However, while in sucrose the glucose is linked to the anomeric carbon of the fructose (an α-1,2 linkage), in isomaltulose the linkage is to the 6 carbon (α-1,6), making isomaltulose a reducing sugar, unlike sucrose. The fructose in isomaltulose exists in a ring structure that readily opens to exhibit a carbonyl group as in ketones and aldehydes, which explains why isomaltulose is a reducing sugar. In comparison with sucrose and most other carbohydrates, Palatinose is believed to be more applicable as a functional alternative sugar than that of as a sugar for calorie.

Controlling bad breath

Bad breath is very common. It can last a short time or can be a chronic problem—lasting for days or months (or even longer). This article talks about some causes of bad breath and offers some tips on controlling it. Several things can cause bad breath, like conditions in your mouth, illnesses in other parts of your body, medications, or certain foods and drinks. Most of the time, chronic bad breath is caused by a problem in your mouth. Some of these conditions are common, such as▪deep cavities;▪dry mouth;▪coating of food and bacteria on the back of the tongue;▪severe gum disease. Bad breath can be a sign of illnesses involving other parts of your body. For example, bacteria associated with bad breath can grow in the nose, sinuses, or tonsils when those tissues are swollen, such as when you have an infection or allergic reaction. Sometimes debris can collect and harden in the folds of the tonsils, forming tonsil stones that can cause bad breath. Conditions that affect the digestive system, like gastric reflux or ulcers, also can cause bad breath. Other illnesses that can affect breath odor include diabetes and liver or kidney failure. Some people develop bad breath while taking certain medications. Medications that might affect breath odor include acetaminophen and some allergy medicines and chemotherapy treatments. Certain foods and drinks can trigger temporary bouts of bad breath. Some of the most well known are garlic, onions, and fish, including tuna. Coffee and alcoholic beverages can dry your mouth, which can also contribute to breath that smells bad. Since most bad breath starts in the mouth, good oral care is a smart first step to controlling breath odor. To help keep your mouth clean▪brush twice a day with a fluoride toothpaste;▪clean between your teeth daily with floss or another product made for this, like tiny brushes, picks, or water flossers. Over-the-counter mouthrinse can help freshen breath. Look for products that have the ADA Seal of Acceptance for the relief of bad breath. These products have been demonstrated to meet ADA Seal standards for safety and efficacy. Pay attention to what you eat and drink. Avoid foods like garlic and onions and limit your consumption of coffee and alcoholic beverages. Drink plenty of water or use sugar-free candies or gum to keep your mouth moist. Talk to your dentist if you are concerned about your breath. He or she can help keep your mouth clean and healthy, which may solve the problem. If your breath is still a concern, your dentist may suggest that you speak with your physician. A number of things can cause bad breath, including your oral or general health. In many cases, brushing and cleaning between your teeth as recommended can help keep your breath fresh. If this does not help, talk to your dentist about possible causes and options for improving the situation.

Nutrition Needs for Patients With Head &amp; Neck Cancer

Nutrition Needs for Patients With Head &amp; Neck Cancer

Malabsorption of fermentable oligo-, di-, or monosaccharides and polyols (FODMAP) as a common cause of unclear abdominal discomfort

Carbohydrate malabsorption is a frequent but underestimated cause of unexplained gastrointestinal symptoms like meteorism, flatulence, pain and diarrhea. By means of hydrogen and/or methane breath test after ingestion of the respective carbohydrate it can be identified and diagnosed easily, fast and reliably by successful nutritional therapy. Besides the well known complaints caused by lactose and fructose malabsorption, other fermentable oligo-, di-, or monosaccharides and polyols (akronym: FODMAP) can cause abdominal discomfort and IBS-like symptoms. In addition to lactose (dairy products) and fructose (apples, pears, mango, watermelon), FODMAPs comprise galactans (legumes), fructans (wheat, onions, garlic, artichoke) and the artificial sweeteners sorbitol, mannitol, maltitol and xylitol (sugar free candy, light products). A general restriction of all FODMAP components can be beneficial in relieving symptoms and improving quality of life in patients with functional gastrointestinal complaints.

Lactobacillus paracasei DSMZ16671 Reduces Mutans Streptococci: A Short-Term Pilot Study

Reducing the burden of pathogenic mutans streptococci is a goal of oral health. Lactobacillus paracasei DSMZ16671, even after heat-killing, specifically co-aggregates mutans streptococci in vitro and retains this activity in human saliva. In rats, it reduces mutans streptococcal colonization of teeth and caries scores. This pilot study sought to assess the potential of heat-killed L. paracasei DSMZ16671 (pro-t-action®) to reduce levels of salivary mutans streptococci in humans, using sugar-free candies as a delivery vehicle. A randomized, placebo-controlled, double-blind in vivo study of three groups examined the short-term effect of sugar-free candies containing 0 (placebo), 1, or 2 mg/candy piece of heat-killed L. paracasei DSMZ16671 on the levels of salivary mutans streptococci determined before and after consumption of the candies. The candies were consumed 4 times during 1.5 consecutive days. Compared to the placebo group, the test groups’ saliva had significantly reduced mutans streptococci as an immediate effect. These results suggest the use of heat-killed L. paracasei DSMZ16671 in suckable candies as a method to reduce mutans streptococci in the mouth and, thereby, caries risk. We think this a new concept and strategy for caries prevention and management.

Sugar-free menthol candy drops improve the palatability and bowel cleansing effect of polyethylene glycol electrolyte solution

Colon preparations are generally poorly tolerated. To study the efficacy of sugar-free candy drops in improving palatability and tolerability of polyethylene glycol electrolyte solution (PEG-E). Single-blind, randomized, controlled trial. University medical center. Ambulatory patients scheduled for elective colonoscopy. Menthol candy drops. Patients were randomly assigned to split-dose, 4-L, PEG-E ± cough drops. Palatability was assessed on a linear scale of 1 to 5 (1 = disgusting; 5 = tasty). Quality of preparation, remaining unconsumed volume, and side effects were secondary outcomes. Palatability and tolerability of PEG-E. A total of 99 patients were enrolled (50 control group, 49 candy drops-added group). The mean (± standard deviation) palatability score was significantly better in candy drop users versus controls (3.9 ± 0.7 vs 2.8 ± 1.2, respectively; P < .001) as were the preparations scored as excellent (63.3% vs 34% of controls; P = .004). Side effects were similar except for nausea (24.5% candy drops vs 44% controls; P = .04). The amount of unconsumed PEG-E was not different between candy drop and control groups (128 [± 361 mL] versus 69 [± 194 mL], respectively; P = .32) but was significantly lower in excellent grade preparations versus other grades (31 [± 103 mL] versus 162 [± 384 mL], respectively; P = .024). On multivariate logistic regression, an excellent preparation was associated with candy drops (odds ratio [OR] 3.3, 95% confidence interval [CI], 1.4-7.8; P = .006) and smaller unconsumed volume of same-day PEG-E [OR 0.996, 95% CI, 0.992-1.000; P = .044). Single-center study. Sugar-free menthol candy drops are a safe and effective addition to split-dose PEG-E, resulting in improved tolerability and patient compliance, which appears to translate into improved bowel cleansing. ( NCT01541683.).

Salivary flow patterns and the health of hard and soft oral tissues

This nonsystematic review summarizes the effects of saliva on some of the diseases affecting the hard and soft oral tissues. Saliva enters the mouth at several locations, and the different secretions are not well-mixed. Saliva in the mouth forms a thin film, the velocity of which varies greatly at different sites. This variation appears to account for the site specificity of smooth-surface caries and supragingival calculus deposition. Saliva protects against dental caries, erosion, attrition, abrasion, candidiasis and the abrasive mucosal lesions seen commonly in patients with hyposalivation. These effects are the result of saliva's being a source of the acquired enamel pellicle; promoting the clearance of sugar and acid from the mouth; being supersaturated with respect to tooth mineral; containing buffers, urea for plaque base formation, and antibacterial and antifungal factors; and lubricating the oral mucosa, making it less susceptible to abrasive lesions. For optimal oral health, people should keep food and liquids in the mouth as briefly as possible. The most important time for toothbrushing is just before bedtime, because salivary flow is negligible during sleep and the protective effects of saliva are lost. Chewing sugar-free gum or sucking on sugar-free candies stimulates salivary flow, which benefits hard and soft oral tissues in many ways.

Effects of Isomalt on enamel de- and remineralization, a combined in vitro pH-cycling model and in situ study

Isomalt is a non-cariogenic sweetener, which is widely used in sugar-free candy and chewing gum. Little is known about the effects of Isomalt on de- and remineralization. Binding between calcium and Isomalt has been reported, which could affect the mineral balance. The objective of this study was to examine the effects of Isomalt on de- and remineralization of bovine enamel lesions, both in vitro and in situ. In in vitro study, subsurface enamel lesions were subjected to 3-weeks pH-cycling. Treatments were 5-min rinses with 10% Isomalt solutions daily and 10% Isomalt additions to re- or demineralizing solutions. Standard pH-cycling conditions were used with a 0.2 ppm fluoride background during the remineralization phase. In in situ study, subsurface lesions were exposed 2 months in vivo and brushed three times daily with 10% Isomalt containing toothpaste. Treatment effects were assessed by chemical analysis of the solutions (in vitro) and transversal microradiography (in vitro and in situ). In in vitro study, while 5-min rinses with 10% Isomalt gave slightly increased remineralization, continuous presence of 10% Isomalt (in re- or demineralizing solutions) inhibited both de- and/or remineralization. This lead to significantly smaller overall mineral loss when Isomalt was added during demineralization. In in situ study, remineralization enhancement during short Isomalt treatments was confirmed. Isomalt had a positive effect on the de/remineralization balance when given under conditions relevant to practical use.

Dietary Habits and Dental Caries in a Population of Spanish Schoolchildren with Low Levels of Caries Experience

The aim of this study was to analyze the relationship between current dietary habits and dental caries in schoolchildren from an area of Spain on which the prevalence of caries was low. The results of an epidemiological study conducted on a random sample of 893 children from the cities of Girona and Figueres are presented. The method of dietary interview consisted of a food-frequency questionnaire. This showed a positive relationship between dental caries and consumption of ice cream, pastries, cakes, sliced bread, on the one hand, and sugar-free chewing gum and sugar-free candies, on the other. A protective effect of skimmed milk and artificial sweeteners was also observed. Results reflect the role of certain foods in caries development, but also the outcome of selective dietary counseling to high-risk children.