The Role of Dietary Ingredients in Mental Energy - A Scoping Review of Randomized Controlled Trials.

Low mental energy can contribute to decreased productivity, altered life balance, decreased physical performance, and ultimately affect quality of life. As such, there is a great demand for food and beverage products that positively impact mental energy. Numerous products claim to alter mental energy making continued review of the scientific evidence critical. The objective of this study was to conduct a scoping review of randomized controlled trials to evaluate the effect of 18 dietary ingredients on mental energy outcomes in adults without severe disease. Methods: A literature search, completed using PubMed, resulted in the identification of 2261 articles, 190 of which met eligibility from initial abstract review. Full-text review was completed on the 190 studies which resulted in 101 articles that fully met eligibility for inclusion in this study. The search strategy for two ingredients did not yield any eligible studies, leaving studies for 16 ingredients that were extracted and summarized by reported significantly improved outcomes for cognition, mood and perceived feelings, and sleep assessments. The preliminary results for several dietary ingredients directionally suggested a mental energy benefit (≥20% of outcomes), including ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, tart cherries, turmeric, and valerian root. The results of this scoping review suggest that of the 16 dietary ingredients reviewed, 11 may be promising for further exploration on their potential benefits in supporting mental energy. Given consumer demand and market growth for food and beverage products that positively impact mental energy; continued efforts in assessment method alignment and additional evaluation in well-designed trials is warranted.KEY TEACHING POINTSOf the 16 dietary ingredients reviewed, 11 (ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, melatonin foods, turmeric, and valerian root) may be promising for further exploration on their potential mental energy benefits.Dark chocolate, ginseng, ashwagandha, and lion's mane mushroom were the most promising ingredients for further evaluation in the cognition domain of the ingredients evaluated.Turmeric, maca, lavendar, and ashwagandha were the most promising ingredients for further evaluation in the mood and perceived feelings domain of the ingredients evaluated.Ashwagandha, chamomile, green tea, melatonin foods, valerian root were the most promising ingredients for further evaluation in the sleep domain of the ingredients evaluated.Additional, well-designed, consistent, clinical trials and systematic reviews are warranted as the challenge of heterogeneity in mental energy study design remains.

Whole grain intake, compared to refined grain, improves postprandial glycemia and insulinemia: a systematic review and meta-analysis of randomized controlled trials.

Whole grain (WG) intake has been associated with reduced risk of type 2 diabetes (T2D) and may protect against T2D by lowering postprandial glycemia and insulinemia and improving insulin sensitivity. The objective of this systematic review and meta-analysis was to evaluate the effect of WG intake, compared to refined grain (RG) intake, on postprandial glycemia and insulinemia and markers of glycemic control and insulin resistance in randomized controlled trials (RCTs) in adults. A search of PubMed and Scopus yielded 80 relevant RCTs. Compared to RG, WG intake significantly reduced postprandial glycemia (SMD: -0.30; 95% CI: -0.43, -0.18; P < 0.001), insulinemia (SMD: -0.23; 95% CI: -0.35, -0.10; P < 0.001) and glycated hemoglobin (HbA1c) (SMD: -0.21; 95% CI: -0.37, -0.06; P = 0.007). There was no effect of WG on fasting glucose, fasting insulin, or homeostatic model assessment of insulin resistance (HOMA-IR). These results suggest WG foods improve short-term glycemia and insulinemia, which may improve HbA1c, a marker of long-term glycemic control. This may partially explain the inverse association between WG intake and risk of T2D, but further investigations are needed to understand if short-term reductions in glycemia translate to longer term benefits in reducing the risk of T2D.Systematic Review Registration: PROSPERO Registration CRD42020180069.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2017838.

Precision nutrition: Maintaining scientific integrity while realizing market potential.

Precision Nutrition (PN) is an approach to developing comprehensive and dynamic nutritional recommendations based on individual variables, including genetics, microbiome, metabolic profile, health status, physical activity, dietary pattern, food environment as well as socioeconomic and psychosocial characteristics. PN can help answer the question "What should I eat to be healthy?", recognizing that what is healthful for one individual may not be the same for another, and understanding that health and responses to diet change over time. The growth of the PN market has been driven by increasing consumer interest in individualized products and services coupled with advances in technology, analytics, and omic sciences. However, important concerns are evident regarding the adequacy of scientific substantiation supporting claims for current products and services. An additional limitation to accessing PN is the current cost of diagnostic tests and wearable devices. Despite these challenges, PN holds great promise as a tool to improve healthspan and reduce healthcare costs. Accelerating advancement in PN will require: (a) investment in multidisciplinary collaborations to enable the development of user-friendly tools applying technological advances in omics, sensors, artificial intelligence, big data management, and analytics; (b) engagement of healthcare professionals and payers to support equitable and broader adoption of PN as medicine shifts toward preventive and personalized approaches; and (c) system-wide collaboration between stakeholders to advocate for continued support for evidence-based PN, develop a regulatory framework to maintain consumer trust and engagement, and allow PN to reach its full potential.

Effects of Whole Grain Intake, Compared with Refined Grain, on Appetite and Energy Intake: A Systematic Review and Meta-Analysis.

Results from observational studies indicate that whole grain (WG) intake is inversely associated with BMI and risk of weight gain. WG intake may influence energy balance and body composition through effects on appetite and energy intake. To evaluate the impact of WG food consumption on appetite and energy intake, a systematic review and meta-analysis was performed of results from randomized controlled trials (RCTs) assessing WG food consumption, appetite, and energy intake in adults. A search of PubMed, Scopus, and Food Science and Technology Abstracts yielded 36 RCTs measuring subjective appetite ratings after consuming WG foods compared with refined grain (RG) controls. Thirty-two of these studies reported AUCs for subjective appetite (hunger, fullness, satiety, desire to eat, or prospective consumption) and/or energy intake and were included in the meta-analysis. Pooled estimates from meta-analyses are expressed as standardized mean differences (SMDs). Compared with RG foods, intake of WG foods resulted in significant differences in AUCs for subjective hunger (SMD: -0.34; 95% CI: -0.46, -0.22; P < 0.001), fullness (SMD: 0.49; 95% CI: 0.31, 0.66; P < 0.001), satiety (SMD: 0.33; 95% CI: 0.18, 0.47; P < 0.001), and desire to eat (SMD: -0.33; 95% CI: -0.46, -0.20; P < 0.001). There were small, nonsignificant reductions in prospective consumption ratings (P = 0.08) and energy intake (P = 0.07) with WG intake compared with RG. These results support the view that consumption of WG foods, compared with RG foods, significantly impacts subjective appetite, and might partly explain the inverse associations between WG food intake and risk of overweight, obesity, and weight gain over time. PROSPERO registration: CRD42020148217.

Breakfast consumption modulates postprandial glycaemic, insulinaemic and NEFA response in pre-diabetic Asian males.

Breakfast consumption is associated with a variety of nutritional and lifestyle-related health outcomes. The objective of the present study was to investigate how the consumption of breakfast affected blood glucose, insulin and NEFA profiles. A lower postprandial blood glucose, insulin and NEFA response is associated with a lower risk of development of metabolic diseases. In a randomised crossover non-blind design, thirteen pre-diabetic Chinese adult males (BMI 26·7 (sd 4·2) kg/m2) attended two sessions where they either consumed a high-glycaemic index breakfast or no breakfast consumption. Changes in glycaemic response over 27 h periods were measured using the Medtronic MiniMed iProTM2 continuous glucose monitoring system. Blood samples were collected using a peripheral venous catheter at fixed intervals for 3 h after the test meal and 3 h after standardised lunch consumption. Postprandial glucose, insulin and NEFA response was calculated as total AUC and incremental AUC using the trapezoidal rule that ignored the area under the baseline. It was found that breakfast consumption significantly decreased postprandial glucose, insulin and NEFA excursion response at lunch time (P = 0·001). Consumption of breakfast attenuated blood glucose profiles by minimising glycaemic excursions and reduced both insulinaemic and NEFA responses in pre-diabetic Asian males during the second meal. This simple dietary intervention may be a novel approach to help improve subsequent lunch glycaemic responses in Asians at high risk of developing diabetes.

Daily Sampling Reveals Personalized Diet-Microbiome Associations in Humans.

Diet is a key determinant of human gut microbiome variation. However, the fine-scale relationships between daily food choices and human gut microbiome composition remain unexplored. Here, we used multivariate methods to integrate 24-h food records and fecal shotgun metagenomes from 34 healthy human subjects collected daily over 17 days. Microbiome composition depended on multiple days of dietary history and was more strongly associated with food choices than with conventional nutrient profiles, and daily microbial responses to diet were highly personalized. Data from two subjects consuming only meal replacement beverages suggest that a monotonous diet does not induce microbiome stability in humans, and instead, overall dietary diversity associates with microbiome stability. Our work provides key methodological insights for future diet-microbiome studies and suggests that food-based interventions seeking to modulate the gut microbiota may need to be tailored to the individual microbiome. Trial Registration: ClinicalTrials.gov: NCT03610477.

The Relationship between Whole Grain Intake and Body Weight: Results of Meta-Analyses of Observational Studies and Randomized Controlled Trials.

Results from some observational studies suggest that higher whole grain (WG) intake is associated with lower risk of weight gain. Ovid Medline was used to conduct a literature search for observational studies and randomized controlled trials (RCTs) assessing WG food intake and weight status in adults. A meta-regression analysis of cross-sectional data from 12 observational studies (136,834 subjects) and a meta-analysis of nine RCTs (973 subjects) was conducted; six prospective cohort publications were qualitatively reviewed. Cross-sectional data meta-regression results indicate a significant, inverse correlation between WG intake and body mass index (BMI): weighted slope, -0.0141 kg/m2 per g/day of WG intake (95% confidence interval (CI): -0.0207, -0.0077; r = -0.526, p = 0.0001). Prospective cohort results generally showed inverse associations between WG intake and weight change with typical follow-up periods of five to 20 years. RCT meta-analysis results show a nonsignificant pooled standardized effect size of -0.049 kg (95% CI -0.297, 0.199, p = 0.698) for mean difference in weight change (WG versus control interventions). Higher WG intake is significantly inversely associated with BMI in observational studies but not RCTs up to 16 weeks in length; RCTs with longer intervention periods are warranted.

Effect of whole-grain consumption on changes in fecal microbiota: a review of human intervention trials.

Whole-grain (WG) consumption is known to have beneficial effects on human health. However, the influence of WGs on the microbiota is not well understood. To evaluate how WG intake modulates the gut microbiota composition, a literature review of human intervention studies was conducted. Whole grain, whether a mixed WG food or diet (n = 5) or specific WG intervention (WG wheat [n = 5], barley [n = 2], rye [n = 2] or rice, corn, or oats [n = 1 for each]), generally modified microbiota composition but did so inconsistently across measurements of microbial diversity and taxa. Interventions used both parallel and crossover designs and varied from single product substitutions to fully controlled diets with WG exposures of 3-12 weeks. The effect of amount of WG was difficult to capture due to variable reporting of WG. Methods used to measure microbiota varied in ability to resolve changes at different taxonomic levels, and comparisons of interventions using similar methods was lacking. Because many dietary components besides WGs alter gut microbiota, further research is needed, particularly in linking microbiota changes to health outcomes, and study design recommendations for future research on WGs and microbiota are warranted.

Evaluating Whole Grain Intervention Study Designs and Reporting Practices Using Evidence Mapping Methodology.

Consumption of whole grains have been associated with reduced risk of chronic diseases in many observational studies; yet, results of intervention studies are mixed. We aimed to use evidence mapping to capture the methodological and reporting variability in whole grain intervention studies that may contribute to this inconsistency. We conducted a reproducible search in OVID Medline for whole grain human intervention studies (published 1946 to February 2018). After screening based on a priori criteria, we identified 202 publications describing a total of 213 unique trials. Over half (55%) were acute trials, lasting ≤1 day, 30% were moderate duration studies (up to 6 weeks) and 15% were of longer duration (more than 6 weeks). The majority of acute trials (75%) examined measures of glycaemia and/or insulinemia, while most of the longer trials included measures of cardiometabolic health (71%), appetite/satiety (57%) and weight/adiposity (56%). Among the moderate and long duration trials, there was a wide range of how whole grains were described but only 10 publications referenced an established definition. Only 55% of trials reported the actual amount of whole grains (in grams or servings), while 36% reported the amount of food/product and 9% did not report a dose at all. Of the interventions that provided a mixture of whole grains, less than half (46%) reported the distribution of the different grain types. Reporting of subject compliance also varied and only 22% used independent biomarkers of whole grain intake. This evidence map highlights the need to standardize both study protocols and reporting practices to support effective synthesis of study results and provide a stronger foundation to better inform nutrition scientists and public health policy.

The glycaemic index and insulinaemic index of commercially available breakfast and snack foods in an Asian population.

A low-glycaemic-index (GI) breakfast has been shown to lower blood glucose levels throughout the day. A wide variety of breakfast foods are consumed, but their GI values are largely unknown, hence limiting consumers' ability to select healthier options. This study investigated the GI values of ten common breakfast (five Asian and five Western) foods in this region using a randomised, cross-over study design. Participants arrived after an overnight fast, and fasting blood sample was taken before participants consumed test foods. Next, blood samples were taken at fixed intervals for 180 min. Glycaemic and insulinaemic responses to test foods were calculated as incremental AUC over 120 min, which were subsequently reported as glycaemic and insulinaemic indices. In all, nineteen healthy men (nine Chinese and ten Indians) aged 24·7 (sem 0·4) years with a BMI of 21·7 (sem 0·4) kg/m2 completed the study. Asian breakfast foods were of medium (white bun filled with red bean paste=58 (sem 4); Chinese steamed white bun=58 (sem 3)) to high GI (rice idli=85 (sem 4); rice dosa=76 (sem 5); upma=71 (sem 6)), whereas Western breakfast foods were all of low GI (whole-grain biscuit=54 (sem 5); whole-grain biscuit filled with peanut butter=44 (sem 3); whole-grain oat muesli=55 (sem 4); whole-grain oat protein granola=51 (sem 4); whole-grain protein cereal=49 (sem 3)). The GI of test foods negatively correlated with protein (r s -0·366), fat (r s -0·268) and dietary fibre (r s -0·422) (all P<0·001). GI values from this study contribute to the worldwide GI database, and may assist healthcare professionals in recommending low-GI breakfast to assist in lower daily glycaemia among Asians who are susceptible to type 2 diabetes mellitus.

Phenolics from Whole Grain Oat Products as Modifiers of Starch Digestion and Intestinal Glucose Transport.

Four oat varieties and three product forms (porridge, cereal, and snack bar) were assessed to determine the impact of oat phenolics on starch digestibility and intestinal glucose transport. α-Amylase activity was enhanced by 20 GAE µM (gallic acid equivalent) of phenolics extracted from oat (96.7-118%, p < 0.05), while it was modestly inhibited at 500 GAE µM (83.0-95.4%). Maltose hydrolysis was reduced (49.6-82.4%, p < 0.05), albeit with high IC50 values (500-940 GAE µM). Free and bound oat phenolic extracts dose-dependently attenuated transport of d-glucose-1,2,3,4,5,6,6-d7 by Caco-2 monolayers over 60 min. Oat foods were then subjected to a coupled in vitro digestion/Caco-2 intestinal cell model to determine relevance to whole food systems. Digestive release of glucose was similar among products; however, glucose transport was significantly reduced from digesta of GMI 423 porridge and puffed cereal by 34% ± 12% and 20% ± 10% (p < 0.05) at 60 min. Results suggest phenolics might be a factor modulating glycemic response of oat products.

Substituting whole grains for refined grains in a 6-wk randomized trial has a modest effect on gut microbiota and immune and inflammatory markers of healthy adults.

Background: Observational studies suggest an inverse association between whole-grain (WG) consumption and inflammation. However, evidence from interventional studies is limited, and few studies have included measurements of cell-mediated immunity.Objective: We assessed the effects of diets rich in WGs compared with refined grains (RGs) on immune and inflammatory responses, gut microbiota, and microbial products in healthy adults while maintaining subject body weights.Design: After a 2-wk provided-food run-in period of consuming a Western-style diet, 49 men and 32 postmenopausal women [age range: 40-65 y, body mass index (in kg/m2) <35] were assigned to consume 1 of 2 provided-food weight-maintenance diets for 6 wk.Results: Compared with the RG group, the WG group had increased plasma total alkyresorcinols (a measure of WG intake) (P < 0.0001), stool weight (P < 0.0001), stool frequency (P = 0.02), and short-chain fatty acid (SCFA) producer Lachnospira [false-discovery rate (FDR)-corrected P = 0.25] but decreased pro-inflammatory Enterobacteriaceae (FDR-corrected P = 0.25). Changes in stool acetate (P = 0.02) and total SCFAs (P = 0.05) were higher in the WG group than in the RG group. A positive association was shown between Lachnospira and acetate (FDR-corrected P = 0.002) or butyrate (FDR-corrected P = 0.005). We also showed that there was a higher percentage of terminal effector memory T cells (P = 0.03) and LPS-stimulated ex vivo production of tumor necrosis factor-α (P = 0.04) in the WG group than in the RG group, which were positively associated with plasma alkylresorcinol concentrations.Conclusion: The short-term consumption of WGs in a weight-maintenance diet increases stool weight and frequency and has modest positive effects on gut microbiota, SCFAs, effector memory T cells, and the acute innate immune response and no effect on other markers of cell-mediated immunity or systemic and gut inflammation. This trial was registered at clinicaltrials.gov as NCT01902394.

Phenolic recovery and bioaccessibility from milled and finished whole grain oat products.

While much is known about the benefits of oat fiber, the relevance of phenolics from oat based food products remains unclear. To gain insight into the relevance of phenolics from consumer oat products, the content of phenolics and avenanthramides (AVEs) was followed in 10 oat cultivars as well as milled oat ingredients and ready to eat (RTE) consumer products (puffed cereals and snack bars). Free phenolic content ranged from 17.2 to 228.1 µg g(-1) DW with AVEs accounting for 57.3-90.6% of the total free phenolics. Bound phenolic content ranged from 141.4 to 680.9 µg g(-1) DW with ferulic acid accounting for 62-94% of the bound phenolics. Select oat groats were ground to flour and prepared as wet cooked porridges (∼20% oat flour in boiling water) or introduced as RTE products into a three stage in vitro digestion to determine phenolic bioaccessibility. The relative bioaccessibility for wet cooked porridges ranged from 0.3-2.6% and from 2.9-28.8% for individual phenolic acids and AVEs, respectively. Puffed oat cereal had significantly higher bioaccessibility compared to matching wet-cook porridge made from the same oat flour (e.g. 83.8% versus 19.1% for AVE A; p < 0.05). Intestinal uptake of bioaccessible oat phenolics from digesta was confirmed by experiments with Caco-2 human intestinal cells. The overall intestinal uptake of oat phenolics was low, ranging between 0.16% and 2.71% across digesta from all oat products. In conclusion, these experiments demonstrate that phenolics naturally present in whole grain oats are recovered well through traditional grain processing, milling and food processing. Furthermore, processing of oat cultivars into a RTE cereal may have a positive impact on the digestive release and bioaccessibility of oat phenolics in the upper GI tract.

Healthy subjects experience bowel changes on enteral diets: addition of a fiber blend attenuates stool weight and gut bacteria decreases without changes in gas.

BACKGROUND: Tube-fed patients frequently suffer from abnormal bowel function that affects intestinal bacteria and quality of life. Dietary fiber affects laxation and can be fermented by gut bacteria to metabolites that influence gut health and fecal moisture. The aim of this study was to compare the effects of a fiber-blend fortified enteral formula (FB, 15 g/L), a fiber-free formula (FF), and habitual diet on bowel function, fecal bacteria, and quality of life. MATERIALS AND METHODS: In a randomized, double-blind, crossover design, 20 healthy subjects consumed both FF and FB for 14 days with a 4-week washout. A 5-day fecal collection was used to assess stool output, whole-gut transit time (WGTT), total bacteria, bifidobacteria, lactobacilli, clostridia, and bacteroides. Subject gastrointestinal quality of life index (GIQLI) and side effects were also measured. RESULTS: On formula diets, 5-day fecal output decreased by >55% from habitual diet, but was 38% higher on FB than FF (P = .0321). WGTT was approximately 1.5 times longer on formula diets than habitual diet (P < .0004). Total bacteria declined from habitual diet on FF (P < .004), but not on FB. Numbers of bifidobacteria and lactobacilli declined from habitual diet on both formula diets, but bifidobacteria was higher on FB compared with FF (P < .0001). Bacteroides and clostridia numbers did not change between diets. GIQLI and incidence of gas symptoms did not differ between formulas. CONCLUSIONS: Addition of a fiber blend moderated changes in bowel function and gut bacteria observed in healthy subjects consuming FF. These results support adding mixed fiber sources to enteral nutrition if no contraindication exists.

Estimation and interpretation of fermentation in the gut: coupling results from a 24 h batch in vitro system with fecal measurements from a human intervention feeding study using fructo-oligosaccharides, inulin, gum acacia, and pea fiber.

Gut bacteria ferment fiber at different rates to primarily short chain fatty acids (SCFA) and gas while proteins are metabolized to SCFA, branched chain fatty acids (BCFA), gas, and undesirable metabolites. Large volumes of gas produced in vivo may contribute to bloating and flatulence in an individual. The objectives of this trial were to (1) compare the in vitro fermentation profiles of fructo-oligosaccharides (FOS), inulin, gum acacia, and pea fiber alone or blended using a 24 h batch model and (2) relate these findings to a human study that fed enteral formula fortified with fiber blend (FB) or no fiber (FF). The in vitro fermentation of the fiber blend resulted in a delayed pH decrease and gas and SCFA production compared to the FOS and inulin. Human samples had higher SCFA on FB compared to FF (p = 0.029). BCFA were not different between formulas. By using a blend of fibers, we observed a slower fermentation in vitro but still increased fecal SCFA when fed to human subjects.

Dissociation characteristic of the inclusion complex of cyclomaltohexaose (alpha-cyclodextrin) with 1-methylcyclopropene in response to stepwise rising relative humidity.

The dissociation of a crystalline complex of cyclomaltohexaose (alpha-cyclodextrin) and 1-methylcyclopropene has been studied in response to stepwise rising relative humidity at 50 degrees C using a dynamic vapor sorption instrument. The dissociation of the inclusion complex was monitored with a proton transfer reaction mass spectrometer. The increase in relative humidity generally triggered the complex dissociation. However, the dissociation was greatly retarded at 80% relative humidity, presumably owing to collapse of the crystalline structure. Abrupt dissociation was observed at 90% relative humidity which corresponded to complex dissolution. The changes in powder X-ray diffraction pattern of the inclusion complex during the storage period were also investigated.