Higher adiposity predicts greater intra-individual inconsistencies in postprandial glycemic measurements-an analysis of three randomized controlled trials in Asian populations.

BACKGROUND/OBJECTIVES: Acute glycemic responses offer important insights into glucose homeostasis although the repeatability of these measurements particularly in Asian populations remains unclear. This research aimed to critically investigate the inconsistencies of the postprandial glycemic profile within individuals, and identify potential variables predicting greater inconsistencies. SUBJECTS/METHODS: This was a secondary analysis of three randomized controlled trials which fed subjects with glucose (and other carbohydrate-rich foods), and measured postprandial blood glucose at regular intervals. Intra-individual rank-order consistency in the glycemic profile between acute glucose treatments was evaluated and compared against demographic, anthropometric and cardio-metabolic health related indicators to delineate potential confounding variables. Correlations between the incremental area under curve at 120 min (iAUC120 min) for glucose and the carbohydrate-rich foods were further explored. RESULTS: Rank-order consistency was identified to be moderate, with intra-individual inconsistencies marginally lower than inter-individual inconsistencies. Notably, greater inconsistencies within individuals were directly correlated with BMI and fat-mass index (P < 0.01) albeit non-significant for age, ethnicity, and other cardio-metabolic health-related risk indicators. Across the trials, there were positive monotonic correlations between the iAUC120 min for glucose and simple sugars (sucrose, isomaltulose), as well as different varieties of rice (jasmine white, Bapatla brown, Bapatla white; p < 0.05). However, there were a lack of associations between iAUC120 min for glucose with pastas (semolina and wholegrain penne, spaghetti) and mee pok noodles. CONCLUSION: There are inherent inconsistencies in postprandial glycemic measurements within individuals, particularly among those with higher adiposity. These confounders need to be kept in mind for appropriate and meaningful interpretations of glycemia.

Plant-Based Meat Analogs and Their Effects on Cardiometabolic Health: An 8-Week Randomized Controlled Trial Comparing Plant-Based Meat Analogs With Their Corresponding Animal-Based Foods.

BACKGROUND: With the growing popularity of plant-based meat analogs (PBMAs), an investigation of their effects on health is warranted in an Asian population. OBJECTIVES: This research investigated the impact of consuming an omnivorous animal-based meat diet (ABMD) compared with a PBMAs diet (PBMD) on cardiometabolic health among adults with elevated risk of diabetes in Singapore. METHODS: In an 8-wk parallel design randomized controlled trial, participants (n = 89) were instructed to substitute habitual protein-rich foods with fixed quantities of either PBMAs (n = 44) or their corresponding animal-based meats (n = 45; 2.5 servings/d), maintaining intake of other dietary components. Low-density lipoprotein (LDL) cholesterol served as primary outcome, whereas secondary outcomes included other cardiometabolic disease-related risk factors (e.g. glucose and fructosamine), dietary data, and within a subpopulation, ambulatory blood pressure measurements (n = 40) at baseline and postintervention, as well as a 14-d continuous glucose monitor (glucose homeostasis-related outcomes; n = 37). RESULTS: Data from 82 participants (ABMD: 42 and PBMD: 40) were examined. Using linear mixed-effects model, there were significant interaction (time × treatment) effects for dietary trans-fat (increased in ABMD), dietary fiber, sodium, and potassium (all increased in PBMD; P-interaction <0.001). There were no significant effects on the lipid-lipoprotein profile, including LDL cholesterol. Diastolic blood pressure (DBP) was lower in the PBMD group (P-interaction=0.041), although the nocturnal DBP dip markedly increased in ABMD (+3.2% mean) and was reduced in PBMD (-2.6%; P-interaction=0.017). Fructosamine (P time=0.035) and homeostatic model assessment for ß-cell function were improved at week 8 (P time=0.006) in both groups. Glycemic homeostasis was better regulated in the ABMD than PBMD groups as evidenced by interstitial glucose time in range (ABMD median: 94.1% (Q1:87.2%, Q3:96.7%); PBMD: 86.5% (81.7%, 89.4%); P = 0.041). The intervention had no significant effect on the other outcomes examined. CONCLUSIONS: An 8-wk PBMA diet did not show widespread cardiometabolic health benefits compared with a corresponding meat based diet. Nutritional quality is a key factor to be considered for next generation PBMAs. This trial was registered at https://clinicaltrials.gov/as NCT05446753.

Effects of wolfberry (Lycium barbarum) consumption on the human plasma lipidome and its association with cardiovascular disease risk factors: a randomized controlled trial of middle-aged and older adults.

Background: Long-term wolfberry intake as part of a healthy dietary pattern was recognized to have beneficial vascular outcomes. Characterization of the plasma lipidome may further provide comprehensive insights into pathways underlying these cardiovascular protective effects. Objective: We analyzed the plasma lipidome of subjects who adhered to a healthy dietary pattern either with or without wolfberry and investigated the associations between the plasma lipidomic profile and cardiovascular health-related indicators. Methods: In this 16-week, parallel design, randomized controlled trial, middle-aged and older adults (n = 41) were provided dietary counseling and assigned to either consume or not consume 15 g of wolfberry daily. At baseline and post-intervention, plasma lipidomics was assayed, and its relationships with classical CVD risk factors, vascular health, oxidant burden, carotenoids status, body composition, and anthropometry were examined. Results: From the plasma lipidome, 427 lipid species from 26 sub-classes were quantified. In the wolfberry and control groups, significant changes were prominent for 27 and 42 lipid species, respectively (P < 0.05 with > 0.2-fold change). Fold changes for seven lipid species were also markedly different between the two groups. Examining the relationships between the plasma lipidome and CVD-related risk factors, total cholesterol revealed a marked positive correlation with 13 ceramide species, while HDL-cholesterol which was notably increased with wolfberry consumption showed a positive correlation with 10 phosphatidylcholine species. Oxidant burden, as represented by plasma 8-isoprostanes, was also inversely associated with lipidomic triglycerides and ether-triglycerides (41 species) and directly associated with hexosylceramides (eight species) and sphingomyelins (six species). There were no differential associations with CVD risk detected between groups. Conclusion: Characteristic alterations to the plasma lipidome were observed with healthy dietary pattern adherence and wolfberry consumption. An examination of these fluctuations suggests potential biochemical mechanisms that may mediate the antioxidant and cardiovascular protective effects of healthy dietary pattern adherence and wolfberry intake. This study was registered at clinicaltrials.gov as NCT0353584.

Effects of dietary fat type and emulsification on carotenoid absorption: a randomized crossover trial.

BACKGROUND: Although emerging evidence has suggested that the type and emulsification of dietary fat may be important to carotenoid absorption, these effects have not yet been validated in a human trial. OBJECTIVES: This study aimed to examine the effects of dietary fat type and emulsification on the bioaccessibility and bioavailability of carotenoids from a carotenoid-rich salad. METHODS: An identical salad was used for the in vitro and the human trial. This was paired with 28 g of one of the following 4 different fats: 1) nonemulsified olive oil, 2) emulsified olive oil, 3) nonemulsified coconut oil, and 4) emulsified coconut oil. The bioaccessibility of total carotenoids (TCs) was assessed by a simulated in vitro digestion model. Sixteen subjects consumed salad with 4 test fats in random order, and plasma triglyceride and carotenoid (lutein, zeaxanthin, α-carotene, ß-carotene, and lycopene) concentrations were determined hourly for 10 h following the consumption. The absorption of TC and individual carotenoids was evaluated by the positive incremental AUC (iAUC) of plasma carotenoid concentrations. RESULTS: The bioaccessibility of TC was greater with olive oil (24.0%) than with coconut oil (14.9%), and with the oil being emulsified (23.5%) rather than that being nonemulsified (15.4%). Similarly, the positive iAUC1-10h of TC, α-carotene, and lycopene were 55.2%, 110.8%, and 45.8%, respectively, higher with olive oil than with coconut oil. Emulsified fat induced 40.0% greater positive iAUC1-10h of TC than nonemulsified fat. CONCLUSIONS: The type and emulsification of dietary fat are both essential to carotenoid absorption. Findings from this study may provide scientific support for designing excipient emulsions as potential dietary strategies to optimize the absorption of fat-soluble compounds. This study was registered at clinicaltrials.gov as NCT04323826.

Measures of carbohydrate quality and their association with diet quality and cardiometabolic health outcomes in Singapore middle-aged and older adults.

BACKGROUND AND AIMS: Carbohydrate quality may play a key role in cardiometabolic health and disease risk. This study aimed to assess the dietary carbohydrate quality of the free-living middle-aged and older adults in Singapore, and its association with overall diet quality and cardiometabolic health. METHODS AND RESULTS: This cross-sectional study examined the diet and cardiometabolic disease risk indicators of middle-aged and older adults in Singapore (n = 104). Dietary carbohydrate quality was assessed as the pass and fail rate of the population to four measures of carbohydrate quality: (i) dietary fiber recommended daily allowance (RDA), (ii) whole-grain recommendation, (iii) free sugar recommendation, and (iv) carbohydrate metrics. The association between each carbohydrate quality measure and diet quality, as well as cardiometabolic health, was assessed. Except for free sugar recommendation, the carbohydrate quality of the population was found to be poor with a low adherence (20-36%) to three measures. Subjects meeting these measures had generally higher intakes of fiber, protein, and most micronutrients compared with subjects who failed. Meeting different variants of the carbohydrate metrics was associated with 60% lower odds of pre-hypertensive blood pressure (p = 0.037; p = 0.047), and meeting the dietary fiber RDA was associated with lower waist circumference (p = 0.021). CONCLUSION: An improvement in carbohydrate quality is warranted among free-living middle-aged and older adults in Singapore. Not all measures of carbohydrate quality were equally effective in preserving overall diet quality; the carbohydrate metrics and dietary fiber RDA can be identified as effective measures in relation to cardiometabolic disease risk. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ CLINICAL TRIAL REGISTRATION: NCT03554954, 13 Sept. 2018.

Association Between Dietary Protein Intake and Sleep Quality in Middle-Aged and Older Adults in Singapore.

Poor sleep has been associated with the increased risk of developing detrimental health conditions. Diet and certain nutrients, such as dietary protein (PRO) may improve sleep. This cross-sectional study aimed to investigate the relationship between PRO intake, their amino acid components, and sources with sleep quality in middle-aged and older adults residing in Singapore. A dataset of 104 healthy subjects between the age of 50 and 75 years old were used. Collected data included 3-day food record and sleep quality [sleep duration, global sleep score (GSS), sleep latency (SL), and sleep efficiency (SE)]. The collected 3-day food records were extracted for PRO, tryptophan (Trp), and large neutral amino acid (LNAA) intake. PRO intake was further categorized into plant and animal PRO. A multivariate multiple linear regression (MLR) was performed to assess the association between PRO intake and sleep quality. Dietary Trp:LNAA ratio was positively associated with sleep duration (ßtotal: 108.234 h; p: 0.005) after multiple covariates adjustment. Similarly, plant Trp (ßplant: 2.653 h/g; p: 0.020) and plant Trp:LNAA (ßplant: 54.006 h; p: 0.008) was positively associated with sleep duration. No significant associations were observed for both SL and SE. Sleep duration in middle-aged and older Singaporean adults was positively associated with dietary Trp and Trp:LNAA, especially when obtained from plant sources.

Cardiovascular disease risk reduction with wolfberry consumption: a systematic review and meta-analysis of randomized controlled trials.

PURPOSE: Wolfberry is rich in bioactive compounds which may lower cardiovascular disease risk. This meta-analysis aimed to systematically evaluate the effects of wolfberry-based randomized controlled trials (RCTs) on overall cardiovascular health. METHODS: Four online databases (PubMed, CINAHL Plus, Medline and Cochrane Library) were searched to shortlist relevant RCTs. Outcomes of interests included blood lipids and lipoproteins, blood pressure, biomarkers of oxidative stress, inflammation and other cardiovascular health-related indicators. Random-effects models were used to provide a weighted mean difference (WMD) and/or Hedges' g for quantitative synthesis. This was coupled with subcategory analyses which stratified RCTs according to the form in which wolfberry was administered (whole wolfberry versus wolfberry extract). RESULTS: From the 785 articles identified, 10 were selected for meta-analysis. Compared to the control, groups which consumed wolfberry showed a reduction in blood triglycerides [WMDpooled (95% confidence interval): - 0.14 (- 0.19, - 0.09) mmol/L] and increased blood high-density lipoprotein cholesterol [WMDpooled: 0.06 (0.02, 0.09) mmol/L]. Notably, effects for both triglycerides [WMDwhole: - 0.14 (- 0.19, - 0.09) mmol/L; WMDextract: - 0.07 (- 0.30, 0.16) mmol/L] and high-density lipoprotein cholesterol [WMDwhole: 0.06 (0.02, 0.09) mmol/L; WMDextract: 0.05 (- 0.02, 0.13) mmol/L] were more prominent after whole wolfberry interventions. Additionally, blood malondialdehyde equivalents were also significantly decreased in wolfberry consuming groups [Hedges' gpooled: - 1.45 (- 2.75, - 0.16)]. No changes were observed for the other lipids and lipoproteins as well as blood pressure. CONCLUSIONS: Wolfberry consumption is effective in improving blood lipids and lipoproteins profile and lowering oxidative stress. This supports the incorporation of wolfberry, particularly as whole fruits, into dietary patterns targeted at improving cardiovascular health.

Impact of following a healthy dietary pattern with co-consuming wolfberry on number and function of blood outgrowth endothelial cells from middle-aged and older adults.

Blood outgrowth endothelial cells (BOECs) have received growing attention in relation to cardiovascular disease (CVD). However, the effect of diet intervention, a primary strategy for CVD prevention, on BOECs is not reported. This study aims to investigate the effect of following a healthy dietary pattern (HDP) with or without wolfberry consumption, healthy food with potential cardiovascular benefits, on the number and function of BOECs in middle-aged and older adults. Twenty-four subjects consumed either an HDP only (n = 9) or an HDP supplemented with 15 g day-1 wolfberries (n = 15) for 16 weeks. At pre- and post-intervention, vascular health biomarkers and composite CVD risk indicators were assessed. BOECs were derived from peripheral blood mononuclear cells and their angiogenic and migration activities were measured. Isolated BOECs have typical endothelial cobblestone morphology, express von Willebrand factor and KDR. Consuming an HDP improved the BOEC colony's growth rate, which was demonstrated by significant time effects in the colony's culture time between passages 1 and 2 (P = 0.038). Both interventions increased BOECs' tube formation capacity. Moreover, HDP intervention contributed to a time effect on BOEC migration activity (P = 0.040 for t1/2gap). Correlation analysis revealed that BOEC colony number was positively associated with blood pressure, atherogenic index, vascular age, and Framingham risk score. In conclusion, adherence to an HDP improved BOECs' function in middle-aged and older populations, while additional wolfberry consumption did not provide an enhanced effect. Our results provide mechanistic dissection on the beneficial effects on BOECs of dietary pattern modification.

A Systematic Review and Meta-Analysis of the Impact of Different Intensity of Dietary Counselling on Cardiometabolic Health in Middle-Aged and Older Adults.

Dietary counselling has been identified as one of the nutritional strategies to alleviate cardiometabolic health conditions. Its effectiveness however may vary due to factors such as intensity level and provider while this has not been comprehensively studied. This systematic review and meta-analysis aimed to assess the effects of dietary counselling on the cardiometabolic health in middle-aged and older adults and the sub-group analyses with dietary counselling intensity and the provider were also assessed. Four databases including PubMed, CINAHL Plus with Full Text, Cochrane Library and EMBASE were systematically searched. Data from 22 randomised controlled trials (RCTs) were compiled and those from 9 RCTs were utilised for meta-analysis. Dietary counselling lowered total cholesterol (TC) and fasting blood sugar (FBS) but had no impact on triglycerides (TG) and low-density lipoprotein (LDL). Sub-group analysis revealed significant lowering effect of high intensity dietary counselling for TG (weighted mean difference (WMD): -0.24 mmol/L, 95% confidence intervals (CIs): -0.40 to -0.09), TC (WMD: -0.31 mmol/L, 95% CIs: -0.49 to -0.13), LDL (WMD: -0.39 mmol/L, 95% CIs: -0.61 to -0.16) and FBS (WMD: -0.69 mmol/L, 95% CIs: -0.99 to -0.40) while medium or low intensity dietary counselling did not show favouring effects. Counselling provider showed differential responses on cardiometabolic health between dietitian and all other groups. The findings from this systematic review and meta-analysis suggest that dietary counselling is a beneficial dietary strategy to improve cardiometabolic health in middle-aged and older adults with the emphasis on the counselling intensity.

Enhancing the cardiovascular protective effects of a healthy dietary pattern with wolfberry (Lycium barbarum): A randomized controlled trial.

BACKGROUND: The consumption of wolfberry (Lycium barbarum), a rich source of carotenoids and bioactive polysaccharides, may serve as a potential dietary strategy for cardiovascular disease (CVD) risk management although limited studies examined its effects as whole fruits. OBJECTIVES: To investigate the impact of wolfberry consumption as part of a healthy dietary pattern on vascular health-related outcomes and classical CVD risk factors in middle-aged and older adults in Singapore. METHODS: This is a 16-week, parallel design, randomized controlled trial. All participants (n = 40) received dietary counselling to follow healthy dietary pattern recommendations with the wolfberry group given additional instructions to cook and consume 15 g/d whole, dried wolfberry with their main meals. Biomarkers of vascular function (flow-mediated dilation, plasma total nitrate/nitrite, endothelin-1, and intercellular adhesion molecule-1), vascular structure (carotid intima-media thickness) and vascular regeneration (endothelial progenitor cell count, plasma angiopoietin 1 and angiopoietin 2), were assessed at baseline and postintervention. Serum lipid-lipoproteins and blood pressure were evaluated every 4 weeks. RESULTS: All participants showed an improved compliance toward the healthy dietary pattern. This was coupled with marked rises in total nitrate/nitrite concentrations (mean change wolfberry: 3.92 ± 1.73 nmol/mL; control: 5.01 ± 2.55 nmol/L) and reductions in endothelin-1 concentrations (wolfberry: -0.19 ± 0.06 pg/mL; control: -0.15 ± 0.08 pg/mL). Compared with the control which depicted no changes from baseline, the wolfberry group had a significantly higher HDL cholesterol (0.08 ± 0.04 mmol/L), as well as lower Framingham predicted long-term CVD risk (-0.8 ± 0.5%) and vascular age (-1.9 ± 1.0 y) postintervention. No differences were observed in the other vascular health-related outcomes. CONCLUSIONS: In middle-aged and older adults, adherence to a healthy dietary pattern improves vascular tone. Incorporating wolfberry to the diet further improves blood lipid-lipoprotein profile and may lower long-term CVD risk. This study was registered at clinicatrials.gov as NCT03535844.

Wolfberry (Lycium barbarum) Consumption with a Healthy Dietary Pattern Lowers Oxidative Stress in Middle-Aged and Older Adults: A Randomized Controlled Trial.

Incorporating zeaxanthin-rich wolfberry (Lycium barbarum) into a healthy dietary pattern may augment its antioxidant potential. The present 16-week, parallel design randomized controlled trial aimed to investigate the impact of adhering to a healthy dietary pattern, either with or without whole dried wolfberry (15 g/d) on oxidative stress status (plasma malondialdehyde and 8-iso-prostaglandin F2α) in middle-aged and older adults. Changes to carotenoids status (plasma and skin carotenoids) and body composition were further evaluated to explore potential mechanisms which underlie the antioxidant properties of wolfberry. Plasma 8-iso-prostaglandin F2α, plasma zeaxanthin and skin carotenoids status were significantly raised in the wolfberry consuming group (n = 22; p < 0.05) compared to the control group which showed no changes (n = 18). Likewise in the wolfberry group only, inverse association was observed between the change values of plasma zeaxanthin and plasma 8-iso-prostaglandin F2α (-0.21 (-0.43, 0.00) ng/µmol, regression coefficient (95% CI); p = 0.05). Wolfberry consumption with a healthy dietary pattern may serve as a dietary strategy to attenuate lipid peroxidation among middle-aged and older adults who are at a heightened risk of oxidative stress induced age-related disorders. The antioxidant properties of wolfberry may be attributed to its rich zeaxanthin content.

Animal Protein versus Plant Protein in Supporting Lean Mass and Muscle Strength: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Although animal protein is usually considered to be a more potent stimulator of muscle protein synthesis than plant protein, the effect of protein source on lean mass and muscle strength needs to be systematically reviewed. This study aimed to examine potential differences in the effect of animal vs. plant protein on lean mass and muscle strength, and the possible influence of resistance exercise training (RET) and age. The following databases were searched: PubMed, Embase, Scopus and CINAHL Plus with Full Text, and 3081 articles were screened. A total of 18 articles were selected for systematic review, of which, 16 were used for meta-analysis. Total protein intakes were generally above the recommended dietary allowance at the baseline and end of intervention. Results from the meta-analyses demonstrated that protein source did not affect changes in absolute lean mass or muscle strength. However, there was a favoring effect of animal protein on percent lean mass. RET had no influence on the results, while younger adults (<50 years) were found to gain absolute and percent lean mass with animal protein intake (weighted mean difference (WMD), 0.41 kg; 95% confidence interval (CI) 0.08 to 0.74; WMD 0.50%; 95% CI 0.00 to 1.01). Collectively, animal protein tends to be more beneficial for lean mass than plant protein, especially in younger adults.

Skin carotenoid status and plasma carotenoids: biomarkers of dietary carotenoids, fruits and vegetables for middle-aged and older Singaporean adults.

Skin carotenoid status (SCS) measured by resonance Raman spectroscopy (RRS) may serve as an emerging alternative measurement for dietary carotenoid, fruit and vegetable (FV) intake although its application had not been assessed in a middle-aged and older population in Asia. This cross-sectional study aims to concurrently examine the use of SCS and plasma carotenoids to measure FV and carotenoid intake in a middle-aged and older population, taking into consideration potential socio-demographic and nutritional confounders. The study recruited 103 middle-aged and older adults (mean age: 58 years) in Singapore. Dietary carotenoids and FV, plasma carotenoid concentration and SCS were measured using 3-d food records, HPLC and a biophotonic scanner which utilised RRS, respectively. Adjusted for statistically defined socio-demographic covariates sex, age, BMI, prescription medication and cigarette smoking, plasma carotenoids and SCS showed positive associations with dietary total carotenoids (ßplasma: 0·020 (95 % CI 0·000, 0·040) µmol/l/mg, P = 0·05; ßskin: 265 (95 % CI 23, 506) arbitrary units/mg, P = 0·03) and FV (ßplasma: 0·076 (95 % CI 0·021, 0·132) µmol/l per FV serving, P = 0·008; ßskin: 1036 (95 % CI 363, 1708) arbitrary units/FV serving, P = 0·003). The associations of SCS with dietary carotenoid and FV intake were null with the inclusion of dietary PUFA, fibre and vitamin C as nutritional covariates (P > 0·05). This suggests a potential influence of these nutritional factors on carotenoid circulation and deposition in the skin. In conclusion, SCS, similar to plasma carotenoids, may serve as a biomarker for both dietary carotenoid and FV intake in a middle-aged and older Singaporean population.

Skin carotenoids status as a potential surrogate marker for cardiovascular disease risk determination in middle-aged and older adults.

BACKGROUND AND AIMS: Upon consumption, carotenoids, which may attenuate cardiovascular disease (CVD) risk, diffuse from the blood and accumulate in the skin. This study aimed to assess the associations between dietary, plasma, and skin carotenoids with CVD risk indicators and to examine the mediational role of plasma carotenoids in the relationship between skin carotenoids status (SCS) and CVD risk. METHODS AND RESULTS: Dietary, plasma, and skin carotenoids were assessed in a cross-sectional study from a community in Singapore (n = 103) aged 50 to 75 y. Multiple linear regression and binary logistics regression models were used to examine the associations between the carotenoids status with classical CVD risk factors and composite CVD risk indicators. After controlling for covariates, SCS and plasma carotenoids were inversely associated with systolic blood pressure (skin: P < 0.001; plasma: P < 0.05) and diastolic blood pressure (skin: P < 0.001; plasma: P < 0.005). Additionally, each increment of 1000 in SCS was associated with an odds ratio of 0.924 (P < 0.01) for metabolic syndrome diagnosis and 0.945 (P < 0.05) for moderate to high CVD risk classification. Associations between SCS and composite CVD risk indicators were null when adjusted for the corresponding plasma carotenoids, indicating complete mediation. Dietary carotenoids, however, showed no relationship with the CVD risk indicators. CONCLUSION: Carotenoids bioavailability may be important for cardiovascular protection. SCS, driven by the corresponding plasma carotenoids, could be a potential noninvasive surrogate marker for CVD risk determination in middle-aged and older adults. CLINICAL TRIAL REGISTRATION: NCT03554954, https://clinicaltrials.gov/. TRIAL REGISTRATION DATE: 13 June 2018.

Daily consumption of essence of chicken improves cognitive function: a systematically searched meta-analysis of randomized controlled trials.

Essence of chicken (EC) is a dietary supplement with potential benefits on one's cognitive performance. The purpose of this meta-analysis is to evaluate the effects of consuming EC on cognitive function, applying extensively represented domains. Six databases were systematically searched to yield 1760 articles. These articles were independently screened to obtain 8 eligible articles with a pooled population of 794 subjects which is more than twice the population size considered in the previous meta-analyses. Largely, favorable effects on cognitive function were observed following daily EC intake, specifically in the working memory domain (standardized mean difference: 0.31, 95% CI: 0.16, 0.46), one of the core components in executive function which showed statistically significant results. Furthermore, the observed results were also robust to sensitivity analyses and subgroup analyses. This suggests that when consumed daily, EC may improve the mental processing aspect of cognitive function amongst the healthy population.

Effects of fatty acids composition in a breakfast meal on the postprandial lipid responses: a systematic review and meta-analysis of randomised controlled trials.

Replacement of food rich in saturated fatty acids (SFAs) with unsaturated fatty acids (UFAs) is a well-known dietary strategy to reduce the risk of cardiovascular disease while its impact on postprandial blood lipids is less examined. This study assessed the effects of fatty acids composition on the postprandial triglycerides and cholesterol responses. Seventeen randomised controlled trials were identified and pooled analysis results revealed that consumption of a UFAs-rich or an SFAs-rich breakfast meal did not acutely affect postprandial triglycerides and cholesterol responses. However, subgroup analysis observed that triglycerides incremental area under the curve was lower with an SFAs-rich meal (SMD: -0.36; 95% CI: -0.57, -0.15) over a less than 8 h duration, while was higher (SMD: 0.59; 95% CI: 0.05, 1.23) over a longer postprandial duration. It suggests that the postprandial duration is of importance when evaluating the effects of fatty acids composition on blood lipid responses.

Incorporating healthy dietary changes in addition to an increase in fruit and vegetable intake further improves the status of cardiovascular disease risk factors: A systematic review, meta-regression, and meta-analysis of randomized controlled trials.

CONTEXT: Fruit and vegetable (FV) intake has been associated with a reduced risk of cardiovascular disease (CVD). Beyond increasing FV intake, the incorporation of other healthy dietary changes may help to further attenuate CVD risk. OBJECTIVE: A systematic review and meta-analysis was conducted to determine the effect of increasing FV intake to > 3 servings daily as well as incorporating other healthy dietary changes on classical CVD risk factors through a systematic review, meta-regression, and meta-analysis of randomized controlled trials. DATA SOURCES: The following databases were searched: PubMed, CINAHL Plus with Full Text, Medline (ProQuest), and Cochrane Library. DATA EXTRACTION: 82, 24, and 10 articles were selected for the systematic review, meta-regression, and meta-analysis, respectively. DATA ANALYSIS: Meta-regression analysis showed a dose-dependent response between the number of FV servings consumed in each intervention group and the blood triglyceride change value. Pooled weighted mean differences from the meta-analysis suggested that increasing FV intake to > 3 servings daily contributes to significant decreases in triglyceride (-0.10 mmol/L; 95%CI, -0.18 to -0.01) and diastolic blood pressure (-1.99 mmHg; 95%CI, -2.28 to -1.70) as well as marginal decreases in total cholesterol and low-density lipoprotein cholesterol. While improvements were observed in the triglyceride and high-density lipoprotein cholesterol response following the incorporation of other healthy dietary changes, no additional cardiovascular benefits were observed when FV intake was increased from > 3 to > 5 servings daily. CONCLUSION: Increasing FV intake to > 3 servings daily improves CVD risk factors, most distinctly triglyceride, especially when complemented with other healthy dietary changes.

Lowering breakfast glycemic index and glycemic load attenuates postprandial glycemic response: A systematically searched meta-analysis of randomized controlled trials.

Low glycemic index (GI) diets are recommended to reduce the risk for chronic diseases by managing postprandial elevations in blood glucose and insulin. However, to our knowledge, a systematic review of randomized controlled trials (RCTs) to investigate this relationship and interpret its clinical relevance has yet to be performed. This review aims to assess the effect of low versus high GI breakfast meals on postprandial glycemic and insulinemic responses in adults. Two researchers independently screened 1100 articles from PubMed, CINAHL, Medline, and Cochrane databases and extracted data from 11 qualified RCTs. Meta-analyses were performed to calculate overall effect sizes of postintervention blood glucose concentration change values at different time points (60, 90, and 120 min) using a random-effects model, reporting their weighted mean differences (WMDs) and 95% confidence intervals (CIs). Low GI breakfasts significantly reduced postprandial blood glucose concentrations at all time points: 60 min (WMD: -1.32 mmol/L; 95% CIs, -1.64 to -0.99), 90 min (WMD: -0.74 mmol/L; 95% CI, -0.92 to -0.56), and 120 min (WMD: -0.44 mmol/L; 95% CI, -0.63 to -0.26). Further analyses not only indicated similar trends following the stratification of studies according to the glycemic load, but also showed a more pronounced decline in glycemic response among individuals with metabolic impairments. These results highlight the benefits of lowering breakfast meal GI to provide clinically relevant reductions in acute glucose response.