Application of Hazard Analysis Critical Control Point in the local manufacture of ready-to-use therapeutic foods (RUTFs).

The local manufacture of ready-to-use therapeutic foods (RUTFs) is increasing, and there is a need to develop methods to ensure their safe production. We propose the application of Hazard Analysis Critical Control Point (HACCP) principles to achieve this goal. The basic principles of HACCP in the production of RUTFs are outlined. It is concluded that the implementation of an HACCP system in the manufacture of RUTFs is not only feasible but also attainable. The introduction of good manufacturing practices, coupled with an effective HACCP system, will ensure that RUTFs are produced in a cost-effective, safe, and hygienic manner.

Polydextrose: its impact on short-term food intake and subjective feelings of satiety in males-a randomized controlled cross-over study.

PURPOSE: Polydextrose is a low-calorie highly branched-chain glucose polymer that is poorly digested in the upper gastrointestinal tract and therefore demonstrates fibre-like properties. Fibre has been shown to increase satiety and possibly reduce food intake. Therefore, the objective of the current study was to examine the effects of polydextrose on short-term satiety and energy intake. METHODS: In a repeated-measures randomized blind cross-over design, 26 healthy males consumed a 400-g fruit smoothie containing 12 g (3 %) of polydextrose, and a buffet lunch 60 min after the smoothie. Motivational ratings for satiety and palatability and lunch energy intake were measured. The effects of the polydextrose-containing smoothie were compared against a polydextrose-free control smoothie. RESULTS: Polydextrose did not significantly alter the taste and palatability of the fruit smoothie. Consuming the polydextrose-containing smoothie resulted in a significantly lower energy intake at lunch (102 kcal less) compared to the control. CONCLUSION: Polydextrose may be a good fortificant for reducing short-term food intake.

Combined medium-chain triglyceride and chilli feeding increases diet-induced thermogenesis in normal-weight humans.

BACKGROUND AND PURPOSE: Capsaicin, the active ingredient of chilli, and medium-chain triglycerides (MCT) have been shown to increase diet-induced thermogenesis (DIT), improve satiety and decrease energy intake. Combinations of thermogenic ingredients have previously been investigated such as mustard and chilli, or capsaicin and green tea with positive effects. The aim of this study was to investigate the combined effects of chilli and MCT feeding on DIT and satiety in healthy volunteers. METHODS: Seven healthy volunteers were tested on four occasions following an overnight fast. Volunteers were fed a breakfast containing chilli and MCT oil, chilli and sunflower oil, bell pepper and sunflower oil or bell pepper and MCT oil. Satiety and gastrointestinal comfort were measured using visual analogue scales (VAS) and category scales. Baseline energy expenditure, and DIT and fat oxidation were measured for 6 h using indirect calorimetry. RESULTS: There were significant differences in DIT between the meals (P = 0.003) which increased from 7.0 % for pepper-sunflower oil to 10.7 % for chilli-MCT oil. The predominant differences existed between the chilli-MCT oil and chilli-sunflower oil (P = 0.013), between chilli-MCT oil and pepper-sunflower oil (P = 0.007) and between pepper-sunflower oil and pepper-MCT oil (P = 0.004). There was a significant difference in fat oxidation between the pepper-sunflower oil and pepper-MCT oil (P = 0.032). There were no differences in any VAS satiety parameters or gastrointestinal comfort ratings. CONCLUSION: Adding chilli and MCT to meals increases DIT by over 50 % which over time may cumulate to help induce weight loss and prevent weight gain or regain.

A comparative evaluation of the glycaemic potential of commercial breads consumed in South East Asia.

Bread has become a widely consumed staple food in South-east Asia. However, there is very little data on the glycaemic potential of local commercial breads. The objective of this study was to comparatively assess the glycaemic potential of some commonly consumed commercial breads using a validated in vitro model. Sixteen types of breads representing the most popular brands and types were evaluated. The results showed that white and enriched white breads had a greater glycaemic potential than wholemeal breads (rapidly digestible starch (RDS) content >450 mg of glucose/g of sample). The lowest glycaemic potential was observed for wholegrain breads (RDS content < 375 mg of glucose/g of sample). The glycaemic impact of some specialty breads such as pandan bread, milk bread and corn loaf was also examined. Whist the data show that South-east Asian breads have notably differential effects on glycaemia, it highlights the need to formulate Asian dietary guidelines for bread which will enable better food choice and glycaemic control.

The influence of saturated fatty acids on complex index and in vitro digestibility of rice starch.

In Asia, rice and rice products are the main sources of carbohydrate contributing to both dietary energy and glycaemic load. It is known that complexation of starch with lipids could potentially reduce the availability of starch to enzymatic degradation. The aim of this study was to investigate the effect of capric, lauric, myristic, palmitic and stearic acids, ranging from 0 to 2 mmol/g starch, on complexing index and in vitro digestibility of gelatinized rice starch. The results revealed that the ability of rice starch to complex with saturated fatty acids increased with increasing concentration; but reduced with increasing lipid chain length. The complexation of rice starch with capric, lauric, myristic and stearic acids did not reduce the in vitro starch digestibility, except rice starch-palmitic acid complexes.

The addition of raspberries and blueberries to a starch-based food does not alter the glycaemic response.

It is now known that health benefits associated with diets rich in fruit and vegetables may be partly derived from intake of polyphenols. Berry polyphenols may influence carbohydrate metabolism and absorption and hence postprandial glycaemia. To date, studies related to polyphenol effects on the glycaemic response have been completed only in liquids using either monosaccharides or disaccharides. It remains to be determined whether berries known to be rich in polyphenols can reduce the glycaemic response (GR) to a solid polysaccharide meal. The aim of the present study was to investigate whether berries alter postprandial hyperglycaemia and consequently the GR to a starchy food. Blood glucose was tested on seven occasions, on three occasions using a reference food and on four occasions using pancakes supplemented with either raspberries or blueberries or control pancakes containing similar amounts of fructose and glucose. Results showed that there were no differences in GR (blueberry 51·3 (SEM 5·7); raspberry 54·7 (SEM 5·6); blueberry control 43·9 (SEM 4·2); raspberry control 41·8 (SEM 6·4)), GR area under the curve or satiety index between any of the tests. The present study indicates that the ability of berries to reduce blood glucose from starch-based foods is unsubstantiated.

Does prolonged chewing reduce food intake? Fletcherism revisited.

Horace Fletcher (1849-1919) spread his doctrine to chew each mouthful thoroughly in order to prevent gaining weight. We sought to test this idea by manipulating chewing instructions whilst using electromyography to monitor chewing behaviour. Comparing 35 with 10 chews per mouthful, we showed that higher chewing counts reduced food intake despite increasing chewing speed, and despite doubling meal duration for achieving a subjective reference point for feeling 'comfortably full'. Although limited by a low sample size, our preliminary findings confirm Mr. Fletcher's doctrine, and provide a basis for further research in this area. Outcomes and implications are discussed.

Liquid and solid carbohydrate foods: comparative effects on glycemic and insulin responses, and satiety.

It is speculated that the physical form (liquid or solid) of the food substrate has an independent effect on the body's satiety mechanisms. Using a balanced and controlled design, the objective of the present study was to determine the glycemic response (GR), insulin response (IR) and subjective feelings of satiety to two solid (rice [BR] and spaghetti) and two liquid (orange juice and a sugar-sweetened fruit drink [SSD]) foods. Ten healthy participants consumed volume (576 ml) and carbohydrate (50 g) matched portions of the above test foods following a 12-h fast. Blood samples were obtained for the ensuing 120 min for glucose and insulin determination. The subjects also completed visual analog scales (VAS) providing data on subjective feelings of hunger, fullness and satiety. Although there were some significant differences in the total incremental areas under the curve for the GR and IR to liquids and solids, there were notable distinctions in the pattern of the response curves. The BR and SSD elicited significantly different levels of subjective hunger, fullness and satiety. The VAS ratings for all four treatments were at or below baseline by 30 min post-consumption. There were no associations between the GR/IR and VAS ratings. Although the GR and IR were not different between liquids and solids, their differential response patterns could have an impact on satiety and merits further investigation.

Glycaemic index and glycaemic load values of a selection of popular foods consumed in Hong Kong.

The objective of the present paper is to provide glycaemic index (GI) and glycaemic load (GL) values for a variety of foods that are commonly consumed in Hong Kong and expand on the international GI table of Chinese foods. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods of various brands of noodles (n 5), instant cereals (n 3) and breads (n 2), which were tested once, on separate occasions. For each test food, tests were repeated in ten healthy subjects. Capillary blood glucose was measured via finger-prick samples in fasting subjects ( - 5, 0 min) and at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI of each test food was calculated geometrically by expressing the incremental area under the blood glucose response curve (IAUC) of each test food as a percentage of each subject's average IAUC for the reference food. GL was calculated as the product of the test food's GI and the amount of available carbohydrate in a reference serving size. The majority of GI values of foods tested were medium (a GI value of 56-69) to high (a GI value of 70 or more) and compared well with previously published values. More importantly, our dataset provides GI values of ten foods previously untested and presents values for foods commonly consumed in Hong Kong.

Role of body composition in the glycaemic response to foods fed to three different ethnic groups: a pilot study.

AIM: To examine the role of overweight and obesity on the glycaemic response to foods across the whole population. DESIGN: Randomised, repeated measures design. SETTING: Oxford, UK. SUBJECTS AND METHODS: Twenty-seven healthy volunteers, 9 Caucasian, 9 Asian, and 9 African, voluntarily participated in the study. The glycaemic response to two breakfast cereals and two bread types was determined in obese and overweight subjects. RESULTS: The current study shows that a very strong correlation exists between fasting blood glucose, peak change in glucose and the IAUC for glucose with each of BMI and WC (r = 0.88, 0.92; 0.82, 0.82; 0.91, 0.81; p = 0.01, respectively) for the Caucasian group. In addition, there was a strong significant negative association between the mean GI values of the four foods and the BMI for the Caucasian subjects (r = 0.61, p < 0.05). Furthermore, there was a strong positive significant association between the mean GI values of the four foods and the percentage body fat mass for the Asian subjects (r = 0.67, p < 0.05). CONCLUSIONS: This study has shown that the GI values of foods are affected by body composition in Asian and Caucasian subjects.

Energy and nutrient intakes during different phases of the menstrual cycle in females in the United Arab Emirates.

BACKGROUND/AIMS: Evidence related to the influence of the menstrual cycle on energy and nutrient intakes is inconclusive. The purpose of the present study was to investigate energy and nutrient intakes during different phases of the menstrual cycle in adult females in the United Arab Emirates. METHODS: Forty-three females, aged between 18 and 30 years, were recruited to the study. Subjects were not using oral contraceptive pills and experienced regular menstrual cycles. Food and beverage intake was recorded, using the estimated daily record method, for 2 days of each menstrual cycle phase (pre-menstrual, menstrual and post-menstrual). Energy and nutrient intakes were analysed using Diet5 for Windows. RESULTS: Mean energy intake was significantly lower in the menstrual phase compared to the pre-menstrual phase (p = 0.002), but not the post-menstrual phase. Intakes of macronutrients and micronutrients were higher in the pre-menstrual phase compared to the menstrual and post-menstrual phases. Intakes of carbohydrates, protein and fat were significantly higher in the pre-menstrual phase than in the menstrual phase (p = 0.008, p = 0.001, p = 0.013, respectively). Similarly, intakes of vitamin C and B vitamins were significantly higher in the pre-menstrual phase than in the menstrual phase (p = 0.019, p = 0.05, respectively). CONCLUSION: Energy and nutrient intakes varied during the different phases of the menstrual cycle. These results confirm the hypothesis that food intake differs between different phases of the menstrual cycle.

Oxidative stability and shelf-life evaluation of selected culinary oils.

Four out of eight 'healthier' oils-namely, almond oil, avocado oil, hazelnut oil and macadamia nut oil-studied were rich sources of monounsaturated fatty acids like olive oil. Grape seed oil, rice barn oil (marketed recently), toasted sesame oil and walnut oil contained high levels of essential fatty acids. The order of oxidative stability determined by Rancimat measuring of the induction period at four temperatures (90 degrees C, 100 degrees C, 110 degrees C, and 120 degrees C) was found to be macadamia oil > rice bran oil approximately toasted sesame oil > avocado oil > almond oil > hazelnut oil > grape seed oil > walnut oil. High-level monounsaturated fatty acid oils gave a linear relationship between 100 times the reciprocal of the induction period against the total unsaturated fatty acid content obtained as %C18:2 + 0.08 x C18:1 + 2.08 x %C18:3, while the polyunsaturated fatty acid oils gave an exponential relationship. In the case of rice bran and hazelnut oils, shelf-life prediction from the extrapolation of the Arrhenius plots and the Q(10) factors was compared well with that of storage time given by the oil producers. In the cases of the other oils (with an exception of macadamia nut oil), the predicted shelf-lives were significantly lower than that of the storage times; especially, walnut oil (very prone to oxidation) gave 15-20 times lower shelf-life than the best-before storage life.

Prevalence of overweight and obesity among adult females in the United Arab Emirates.

The purpose of this present study was to investigate the prevalence of overweight and obesity in adult females in the United Arab Emirates. A total number of 724 females, age 20-90 years, were recruited from the seven Emirates. The sample was divided into three age groups, 20 to <30 years, 30 to <60 years and >60 years. Height, weight and mid-upper-arm circumference were measured in each subject. Overweight and obesity were defined as a body mass index of 25.0-29.9 kg/m2 and >30 kg/m2, respectively. The prevalence of overweight and obesity were 27% and 16%, respectively. The age group between 30 and <60 years had the highest prevalence of overweight (33%) and obesity (24%). In conclusion, the findings from our study suggest that a high proportion of adult females in the United Arab Emirates are overweight and obese. The consequences of this are a serious concern for public health and need to be addressed.

Measuring the glycemic index of foods: interlaboratory study.

BACKGROUND: Many laboratories offer glycemic index (GI) services. OBJECTIVE: We assessed the performance of the method used to measure GI. DESIGN: The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. RESULTS: Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). CONCLUSIONS: The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.

The Glycemic Potential of White and Red Rice Affected by Oil Type and Time of Addition.

UNLABELLED: Limited research exists on how different oil types and time of addition affect starch digestibility of rice. This study aimed to assess the starch digestibility of white and red rice prepared with 2 oil types: vegetable oil (unsaturated fat) and ghee (clarified butter, saturated fat) added at 3 different time points during the cooking process ("before": frying raw rice in oil before boiling, "during": adding oil during boiling, and "after": stir-frying cooked rice in oil). Red rice produced a slower digestion rate than white rice. White rice digestibility was not affected by oil type, but was affected by addition time of oil. Adding oil "after" (stir-frying) to white or red rice resulted in higher slowly digestible starch. Red rice cooked using ghee showed the lowest amount of glucose release during in vitro digestion. The addition of ghee "during" (that is boiling with ghee) or "before" (that is frying rice raw with ghee then boiling) cooking showed potential for attenuating the postprandial glycemic response and increasing resistant starch content. This is the first report to show healthier ways of preparing rice. White rice with oil added "after" (stir-fried) may provide a source of sustained glucose and stabilize blood glucose levels. Boiling red rice with ghee or cooking red rice with ghee pilaf-style may provide beneficial effects on postprandial blood glucose and insulin concentrations, and improve colonic health. The encouraging results of the present study justify extending it to an in vivo investigation to conclusively determine the effect of time of addition of fat when rice is cooked on blood glucose homeostasis. PRACTICAL APPLICATION: Rice is a predominant source of energy in most of Asia with excessive consumption of rice being implicated in the rise of type 2 diabetes. Stir-frying white rice can be a source of sustained glucose and provide a stabilizing effect on blood glucose levels. Boiling red rice with ghee or cooking red rice with ghee pilaf-style may provide beneficial effects on postprandial blood glucose and insulin concentrations. This suggests how a single technique of adding fat in the cooking of rice at certain time points may be a useful method in providing taste and lowering glycemia.

The impact of a low glycemic index (GI) breakfast and snack on daily blood glucose profiles and food intake in young Chinese adult males.

OBJECTIVE: Low glycemic index (GI) foods have been suggested to minimize large fluctuations in blood glucose levels and reduce food intake. However, the majority of studies have been conducted on Caucasian populations with limited data on Asians. The objective of this study was to investigate how the provision of a low GI breakfast and afternoon snack affected daily blood glucose profiles and food intake. MATERIALS AND METHODS: In a randomized, controlled crossover non blind design, 11 healthy Chinese male adults (body mass index 22.4 ± 1.3 kg m-2) attended two sessions where they consumed either a high or low GI breakfast and afternoon snack, and a standardized buffet lunch. Daily changes in glycemic response (GR) were measured using the Medtronic MiniMed (Northridge, CA) iPro™2 continuous glucose monitoring system (CGMS). The GR was further calculated to obtain the incremental area under the curve (IAUC). Glycemic variability was calculated as mean amplitude of glycemic excursion (MAGE) and energy intake (kcal) was measured quantitatively at the buffet lunch. RESULTS: Compared to the high GI intervention, the low GI intervention significantly reduced the GR following breakfast (p = 0.02), lunch (p = 0.02) and dinner (p = 0.05). The low GI treatment showed a reduction in daily AUC (p = 0.03). There was a significant reduction in IAUC after a low GI breakfast compared to the high GI breakfast (p = 0.03). The low GI breakfast resulted in a significantly lower food intake at lunch and a resulting decreased energy intake of 285 kcal (p = 0.02). The MAGE was significantly lower during the entire low GI treatment (p = 0.03). CONCLUSIONS: Consumption of a low GI breakfast and afternoon snack was capable of attenuating 24-h blood glucose profiles, minimize glycemic excursions and reduce food intake in healthy Asian males. This simple dietary intervention may be an acceptable approach in improving overall glycemia and energy balance in Asians. CLINICAL TRIAL REGISTRATION NUMBER: NCT02340507.

Glycemic response and glycemic index of semolina spaghetti enriched with barley ß-glucan.

OBJECTIVE: The postprandial glycemic response and glycemic index (GI) of spaghetti made with semolina and the addition of two ß-glucan barley concentrates, Glucagel (GG) and Barley Balance (BB), was studied. METHODS: For each type of ß-glucan concentrate, six spaghetti samples containing increasing percentages (0%, 2%, 4%, 6%, 8%, and 10%) of ß-glucan were made. Nine healthy subjects were recruited for measuring the glycemic response and GI. Subjects were served portions of the test foods (50 g of available carbohydrates) and a reference food (50 g of glucose) on separate occasions. Capillary blood glucose was measured up to 120 min after consuming the spaghetti. The total glycemic response was calculated geometrically as the incremental areas under the curve (IAUC) using the trapezoid rule. The GI was calculated geometrically by expressing the IAUC for the test food as a percentage of each subject's average IAUC for the glucose. RESULTS: The IAUC for spaghetti with and without ß-glucan was significantly less compared with glucose. The GG spaghetti had IAUC values similar to the spaghetti without ß-glucan concentrate. The BB spaghetti showed IAUC values lower than that of the spaghetti without ß-glucan. In particular, the spaghetti with 10% BB had an IAUC 52% lower (P ≤ 0.017) than the spaghetti with ß-glucan. The GI values for spaghetti with GG were statistically similar to the control. The GI of BB spaghetti decreased with increasing BB concentrations. In particular, the GI of 10% BB spaghetti was 54% lower (P ≤0.02; GI = 29) than that of the control (GI = 64). CONCLUSION: The BB concentrate significantly decreases the IAUC and GI of spaghetti at a dose of 10%. GI at the same concentrations does not.

Postmastication digestion factors influence glycemic variability in humans.

The glycemic response (GR) to food is influenced by both intrinsic and extrinsic factors. A consistent observation in GR studies is the wide within- and between-individual variations. The authors hypothesize that between-individual variations in the GR, insulin response (IR) and gastric emptying occur even when food particle size is standardized. Volunteers were tested on 2 nonconsecutive days after an overnight fast in randomized order. On 1 day, the volunteers consumed large (>2000 µm) rice particles, and on the second day, small rice particles (500-1000 µm). Subsequently, gastric emptying using the sodium [(13)C] acetate breath test (for 240 minutes) and GR and IR (for 120 minutes) from finger-prick blood samples were measured. The incremental area under the curve (IAUC) for the GR for small particles varied 45% more compared with whole rice. The small particles elicited a significantly greater GR IAUC than the large particles. The standard deviations associated with the IR IAUC for the small particles was 140% greater than that of the large particles. The total IAUC for IR was also significantly greater for the small particles than the large particles. The between-individual variations associated with gastric emptying times were similar for both samples. The gastric emptying latency phase, lag, and half time were significantly shorter for the small particles. Ingesting small particles causes faster gastric emptying and produces greater glycemic and IRs. Between-individual variations in GR and IR can be observed even when all the food associated factors including ingested particle size (mastication) are controlled for in humans.

No observable differences in glycemic response to maltitol in human subjects from 3 ethnically diverse groups.

Consumption of a low glycemic index (GI) diet may be helpful in the management and prevention of diabetes and cardiovascular disease. The investigation of GI has been predominantly confined to white subjects. We hypothesized that differences in glycemic response (GR) may be observable in subjects of different ethnic origin. The objective of the present study was to determine GR to a high GI (glucose) and low GI (maltitol) test drink in subjects of different ethnic origin. In a randomized, single-blind crossover trial, 10 whites, 10 South Indians and 10 Chinese subjects consumed either glucose or maltitol test drink containing 50 g of one of the test products on different occasions. Capillary blood glucose samples were taken at 15 and 10 minutes before and 0, 15, 30, 45, 60, 90, 120, 150, and 180 minutes after consumption of the test drink. The incremental area under the curve of glucose and maltitol were not significantly different between the 3 groups. The mean GR for maltitol was 33.5% in whites, 32.9% in Chinese, and 23.1% in South Indians. The results presented here confirmed that there are no observable differences noted in GR to a high-GI or low-GI test drink between the 3 ethnically diverse groups. We conclude that different ethnic groups exhibit similar GR to low- and high-GI drinks, and GR to maltitol is similar irrespective of ethnic background.