Chia seed (Salvia hispanica L.) supplementation to the diet of adults with type 2 diabetes improved systolic blood pressure: A randomized controlled trial.

BACKGROUND: Functional food ingredients, such as dietary fiber, long-chain polyunsaturated fatty acids, and high-quality protein, have been shown to help control blood glucose concentration and lower high blood pressure (BP), as well as improving other cardiovascular disease risk factors. However, little research has assessed the impacts of consuming chia seeds, which are rich in these nutrients, on metabolic and physiological outcomes, and results are conflicting. AIM: The study aimed to investigate the possible effects of chia seeds on fasting blood glucose, insulin, glycated hemoglobin, BP, lipid profile, body weight, and the inflammatory marker - high-sensitivity C-reactive protein - in people with type 2 diabetes (T2DM). METHODS: Adults with T2DM (n = 42) were randomly assigned equally to the chia seed group, which consumed 40 g/day chia seeds for 12 weeks, or a control group, which did not consume any supplement. Blood samples were collected at baseline and after a 12-week intervention period to assess the study outcomes, such as glycemic control, BP, cardiovascular risk parameters including lipid profile, inflammatory marker, and body weight. RESULTS: Adjusted for gender and baseline values, the chia seed group had systolic BP (SBP) significantly reduced compared to control [t (1) = 2.867, p = 0.007, η 2 p = 0.174]. No differences were observed in any other parameter tested in the chia seed or control group. CONCLUSIONS: People with T2DM and hypertension, maintaining usual dietary consumption, physical activity pattern, and medications, had significantly reduced SBP compared to the control group when having consumed 40 g/d of chia seeds for 12 weeks.

Distorted weight perception correlates with disordered eating attitudes in Kuwaiti college women.

OBJECTIVE: We investigated the presence of disordered eating attitudes and weight perception among young women at body mass index (BMI) values that correspond to underweight, normal weight, overweight, and obese weight status. METHOD: Data were collected from 1,147 female undergraduate students (89% Kuwaiti nationals) recruited from Kuwait University through employment of the eating attitude test (EAT-26) together with an anonymous, self-administered questionnaire to determine the prevalence of symptomatology indicative of anorexia nervosa and bulimia nervosa. RESULTS: The mean EAT-26 scores differed significantly between the weight categories. More students with overweight and obesity scored above the established EAT-26 cut off value indicating at risk of disordered eating compared to students who were at a normal weight or underweight (52.1% vs. 38.8%, respectively, X2 (1) =16.1, p < .001). Logistic regression analyses showed significantly higher odds ratios (ORs) for the groups with overweight and obesity for dieting and bulimic behaviors, while women at normal and underweight had higher ORs for restrictive oral control behaviors associated with anorexia nervosa. Distorted weight perception was found in all weight categories. DISCUSSION: The high proportion of disordered eating attitudes among Kuwaiti college women could not be attributed to obesity alone as the type of disordered eating behavior varied more by weight perception than by weight status. The high levels of eating disorder related symptoms could be due to a combination of the social influences, diet, and lifestyle of college students. Such factors need to be considered by healthcare professionals as early as possible with more focused programs towards promotion of healthy weight for college students.

High amylose cornstarch preloads stabilized postprandial blood glucose but failed to reduce satiety or food intake in healthy women.

High fiber diets promote satiety and sustain normal blood glucose by delaying digestion and slowing glucose absorption, but their longer-term impact on body weight loss is thought to be due primarily to their lower energy density. Starches that are digested slowly in the small intestine, resistant starches (RS), contribute to a diet's fiber load. The worldwide epidemic of obesity has supported the incorporation of RS in commercial food products to curtail body weight gain. AIM: The present study explored whether consumption of a beverage containing RS, from high amylose cornstarch (Amylose), will lead to higher satiety and lower energy intake (EI). METHODS: Preload beverages containing 75 gm Amylose, Glucose, or a Glucose-Amylose mixture were administered to young healthy females after an overnight fast and blood glucose and appetite measurements were taken at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Calorie intake was assessed at a pizza meal at 2 h (Experiment 1) or 4 h (Experiment 2). RESULTS: The glycemic responses were lower with Amylose: Glucose > Glucose-Amylose > Amylose = water Control (p < 0.0001). Appetite was not affected by the treatments (p > 0.05). EI was lower only after Glucose at 2 h, but unaffected by treatment after 4 h. CONCLUSION: As high amylose cornstarch improves postprandial blood glucose response but has no effect on satiety and EI, a more careful analysis of its benefits for body weight loss is needed. The research was funded by the Research Office of Kuwait University, Grant # FF01/16. STUDY REGISTRATION: TCTR20180815005.

Chickpeas suppress postprandial blood glucose concentration, and appetite and reduce energy intake at the next meal.

The current study was designed to explore the beneficial properties of chickpeas consumption on suppressing appetite, excessive blood glucose excursions, and energy intake (EI) from a subsequent meal. Two caloric preloaded foods, chickpeas, and white bread were compared to water control, fed to healthy female subjects at equal energy density, volume, and available carbohydrate content in two experiments spanning over 60 and 120 min. Blood glucose was measured by a portable glucometer and satiety by using a visual analogue scale questionnaire at baseline and every 15 up to 60 min in both experiments and then every 30 until 120 min in Experiment 2 after the preloads ingestion. A test meal was served at the end of both experiments to calculate EI and percent energy compensation (%EC). The results suggest a reduction of 29-36% in blood glucose concentration, and 83-98% EC after the chickpeas in Experiments 1 and 2 respectively compared to white bread. The average appetite showed a positive association with EI. We conclude that the consumption of chickpeas is beneficial on glycemic control and may help in body weight management through suppressing appetite and energy intake.

Organoleptic and glycemic properties of chickpea-wheat composite breads.

Prevalence of obesity and type-2-diabetes requires dietary manipulation. It was hypothesized that wheat-legume-composite breads will reduce the spike of blood glucose and increase satiety. Four pan bread samples were prepared: White bread (WB) as standard, Whole-wheat bread (WWB), WWB supplemented with chickpea flour at 25 % (25%ChB) and 35 % (35%ChB) levels. These breads were tested in healthy female subjects for acceptability and for effect on appetite, blood glucose, and physical discomfort in digestion. The breads were rated >5.6 on a 9-point hedonic scale with WB significantly higher than all other breads. No difference in area under the curve (AUC) for appetite was found, but blood glucose AUC was reduced as follows: 35%ChB < WB and WWB, WB >25%ChB = WWB or 35%ChB. We conclude that addition of chickpea flour at 35 % to whole wheat produces a bread that is acceptable to eat, causing no physical discomfort and lowers the glycemic response.

Relationship between perceived body image and recorded body mass index among Kuwaiti female university students.

The associations between body image and attitudes toward obesity and thinness and their associations with measured body mass index (BMI) among female students of Kuwait University (n = 137) was examined in 2008. The body image perceptions were assessed using nine female silhouettes figures. The difference between current perceived body image (PBI) and ideal body image (IBI) was used as a measure of body image dissatisfaction (BID). Students tended to have a bigger PBI and smaller IBI than would be expected from their BMI category, leading to high levels of BID in each BMI category. PBI, IBI, BID, RBI were highly correlated with each other, and BMI was significantly correlated with each of them. The coefficients of these associations were not significantly altered in multiple regression analysis by the addition of potential confounding variables, such as age, marital status, physical activity, dieting behavior, parental education, and family size. These results suggest that PBI and a desire to be thinner were strongly related to BID and that thinness is becoming more desired in Kuwaiti society than the plump body image of the past.

Correlates of food intake and mealtime behaviors among Kuwaiti adolescents.

OBJECTIVES: Eating meals with the family improves the food choices of adolescents. Studies conducted on Kuwaiti adolescents have reported suboptimal dietary intake; however, it is unclear what meal-related behaviors and family dynamics influence dietary choices in young Kuwaiti adolescents. This study explored the food intake and meal-related behaviors of young adolescents in relation to their mother's educational level, parental employment, and family size and to identify meal-related behaviors associated with poor dietary choices. CONTENT: A cross-sectional survey was conducted using a modified and validated version of the International Health Behavior in School Children questionnaire recruiting 774 adolescents aged 14-16 years from all six governorates of Kuwait. SUMMARY: A higher level of the mother's education was associated with higher odds of eating fruits and breakfast. A stay-at-home mother was associated with higher odds of consuming milk and home-made desserts. Larger family size was associated with higher odds of eating fruits, and a higher frequency of family meals was associated with higher odds of consuming vegetables and whole grain bread. All unhealthy snacks, including sweets, potato chips, french fries, home-made desserts, and sugar-sweetened beverages, were associated with higher odds of watching TV during mealtime. OUTLOOK: A higher level of mother's education level, large family size, and family meals encouraged consuming fruits, vegetables, whole grain bread, milk, and breakfast, but consuming empty calorie snacks is very common. Family involvement in developing healthy meal-related behaviors is imperative for shaping healthy eating habits of adolescents.

Rheological characteristics of wheat-chickpea composite flour doughs and effect of Amla powder (Phyllanthus emblica L.) addition on the functional properties of bread.

Bread is a staple food for majority of the people worldwide, but it has a high glycemic effect. Substituting wheat flour partly with chickpea flour and the presence of bran is suggested to improve the glycemic effect of bread; however, the non-gluten substances in wheat flour adversely affect dough rheology. The addition of amla powder was tested on the rheological properties of wheat-chickpea flour composite doughs; also, the physical and sensory qualities of bread made thereof. The results showed that when the level of replacement of refined white flour (WF) or whole wheat flour (WWF) with chickpea flour was increased from 0 to 40%, it significantly affected the rheological properties and functionality of dough. A decreased farinograph water absorption, higher mixing tolerance index (i.e., weakening of dough), decreased resistance to extension, and lower ratio numbers were obtained with some differences between WF and WWF at the higher level of chickpea flour substitution. The addition of amla powder to WF: chickpea flour (60:40) blends reduced the angle of ascending (from 7.0 ± 0.7 to 6.0 ± 0.7) and angel of descending (from 3.2 ± 0.21 to 2.4 ± 0.2), indicating the slight tightening of gluten leading to dough breakdown. The addition of amla powder improved the mixing characteristics of the composite flour doughs, as well as the physical and sensory qualities of the bread. In conclusion, amla powder can help overcome the deleterious impact of adding chickpea flour to WF or WWF for producing good quality pan bread for people with type-2 diabetes.

Consumer prevalence, attitude and dietary behavior of online food delivery applications users in Kuwait.

The objective of this research was to estimate the prevalence, attitude and dietary behavior of online food delivery application users in Kuwait. A survey of 1045 participants found that 87.6% of them have ordered food online by mobile app. Talabat was the most common food delivery application used among participants in Kuwait. Fast food was the most commonly ordered category followed by sweets and pastries. The most important attribute of electronic ordering is speed of delivery followed by ease of ordering. Around 73.6% of the participants use food apps to order dinner, and 76.4% order fast food at late night. The majority of online food delivery application users in Kuwait have unhealthy dietary practices. The results emphasize a serious need for implementing a suitable intervention for stimulating healthy eating behaviors among food delivery application users in Kuwait.

Microstructure of Whole Wheat versus White Flour and Wheat-Chickpea Flour Blends and Dough: Impact on the Glycemic Response of Pan Bread.

Whole foods are generally considered healthier choices compared to processed foods. For nutritional consideration, whole wheat bread is recommended over the white bread. However, it has a similarly high effect on glycemic response (GR) as the white bread. This study is aimed at assessing the microstructure of whole wheat flour (WWF), white flour (WF), chickpea flour (BF), their blends, and dough and the GR of the bread made thereof. Scanning electron microscope analysis showed clear distinctions in the microstructure of the three flours. WWF particle size distribution had the widest spread with a polydispersity index (PDI) of 1.0 (±0.0) and wider average diameter, with z value of 1679.5 (±156.3) compared with the particle size of 658.9 (±160.4) and PDI of 0.740 (±0.04) for WF followed by BF with the particle size of 394.1 (±54.9) and PDI of 0.388 (±0.07) (p < 0.05). The falling number was significantly (p < 0.05) lower for WWF compared to WF or BF, indicating higher alpha-amylase activity. Thus, bread made from WWF without BF substitution exhibited a higher glycemic response similar to the bread made from WF. When partly replaced with BF, the GR of the bread made with WWF or WF reduced significantly (p < 0.05) in healthy individuals.

Food intake and satiety following a serving of pulses in young men: effect of processing, recipe, and pulse variety.

BACKGROUND: Diets containing beans have been associated with a lower risk of obesity and overweight in several dietary surveys. These results suggest a benefit might be derived from beans and other pulses, possibly due to improved satiety or satiation and therefore lowering energy intake. Such a hypothesis has not been tested. OBJECTIVES: To investigate the effect of processing, recipe, and pulse variety on short-term food intake (FI), subjective appetite, and glycemic response after pulse consumption in healthy young men. DESIGN: Three experiments were conducted. In a randomized repeated-measures design, young men aged 18-35 years with a body mass index of 20-25 kg/m(2) were fed the test treatments. In experiment 1 (n = 14), navy beans canned in Canada or in the United Kingdom were compared with homemade navy beans and 300 ml of glucose drink, each containing 50 g of available carbohydrate. In experiment 2 (n = 14), canned navy beans in tomato sauce, maple style, with pork and molasses, and homemade navy beans with pork and molasses were compared with white bread, each containing 50 g of available carbohydrate. In experiment 3 (n = 15), 4 equicaloric (300-kcal) treatments of pulses were compared with both a white bread and water control. Blood glucose and subjective appetite were measured from immediately before consumption of the treatment to 120 minutes later when FI from a pizza meal was measured. RESULTS: All caloric treatments decreased subjective appetite. In no experiment did any pulse treatment lower FI at 120 minutes compared with white bread or result in lower cumulative FI (sum of calories from treatment and pizza meal) compared with either 50 g of available carbohydrate as a glucose drink (experiment 1) or from white bread (experiment 2) or compared with equal food energy from white bread (experiment 3). Glycemic response to navy beans was affected by recipe, but not processing, and as with the other pulses, it was lower than with white bread. An inverse relationship was observed between glycemic response and both subjective appetite and FI at 120 minutes in experiment 3 (r = -0.4, p = 0.001) but not in experiments 1 (r = 0.1, p = 0.62) and 2 (r = 0.2, p = 0.10). CONCLUSION: The short-term effect of pulse consumption on subjective appetite and FI at a meal 120 minutes later and in cumulative food intake was determined primarily by energy content and was little influenced by composition, processing, recipe, or variety. Thus, the epidemiological associations between frequent pulse consumption and lower risk of obesity and overweight are not explained by short-term effect of pulses on satiety and FI.

Disordered eating attitudes correlate with body dissatisfaction among Kuwaiti male college students.

BACKGROUND: The prevalence of disordered eating attitudes and body dissatisfaction based on muscularity and body fat was investigated among male college students in Kuwait with a range of body mass index values including underweight, normal weight, overweight, and obese participants. METHODS: Data were collected, using the Eating Attitudes Test (EAT-26) and the Bodybuilder Image Grid (BIG), from 400 male undergraduate students (84.8% Kuwaiti nationals) recruited from both public and private universities in Kuwait. An anonymous, self-administered questionnaire was used to determine the prevalence of symptomatology indicative of anorexia nervosa and bulimia nervosa and to examine the associations between body dissatisfaction and muscularity and body fat. RESULTS: Most participants were dissatisfied with their current muscle mass and body fat (67.3 and 69%, respectively). Logistic regression analyses produced odds ratios (ORs) demonstrating that students dissatisfied with their muscularity and body fat and those who indicated a desire to decrease both muscularity and body fat had significantly higher odds of being at risk of disordered eating attitudes (OR = 2.241, 95% CI [1.17, 3.6], p = .032, and OR = 1.898, 95% CI [1.214, 2.967], p = .005, respectively). Obese participants also had higher odds of exhibiting disordered eating attitudes (OR = 2.06, 95% CI [1.17, 3.60], p = .011). CONCLUSION: The high proportion of disordered eating attitudes among Kuwaiti college men was associated with high levels of body image dissatisfaction in relation to both body fat and muscularity. High levels of eating disorder symptoms were also linked to obesity.

Parboiled rice metabolism differs in healthy and diabetic individuals with similar improvement in glycemic response.

BACKGROUND: White rice is a popular staple food; however, its high glycemic effect makes it an unfavorable choice for people with type 2 diabetes. OBJECTIVES: We hypothesized that the consumption of parboiled rice (PBR) reduces postprandial blood glucose concentration and appetite similarly to brown rice (BR) in diabetic people compared to white rice (WR). The objectives were to explore the effect of PBR on the pattern of blood glucose concentration and satiety in type 2 diabetic patients compared with healthy individuals. METHODS: Subjects were randomly administered 50 g of available carbohydrate from PBR, WR, or BR. Blood glucose and appetite were measured at 0, 15, 30, 45, 60, 90, and 120 min after ingestion of the rice samples. RESULTS: The postprandial blood glucose responses were significant among the healthy and diabetic subjects after consumption of the three rice samples. On the subjective appetite assessment, the response to the amount of food subjects could consume was significantly lower for healthy subjects after ingestion of PBR only. Despite these differences in rice metabolism between the two study groups, the area under the curve for the blood glucose response was reduced by 35% and 38% after consumption of PBR in diabetic and healthy subjects, respectively. Blood glucose responses to WR and BR however, were not significantly different from each other in either group. CONCLUSIONS: We conclude that PBR is a better alternative to WR or BR for diabetic individuals to control postprandial hyperglycemia.

The nutritional status of adult female patients with disabilities in Kuwait.

OBJECTIVES: Adults with disabilities are at a higher risk of malnutrition than are their non-disabled counterparts owing to feeding problems and associated medical conditions. We evaluated the prevalence of malnutrition in a group of institutionalized women and investigated any feeding difficulties and nutrition-related medical problems. METHODS: This study used two versions of the Mini Nutritional Assessment-Short Form (MNA-SF) to screen malnutrition: the MNA-SF1 which uses the body mass index, and the MNA-SF2 which uses the calf circumference. Data were collected from 53 women with intellectual and physical disabilities in a cross-sectional survey of residents of the Kuwait Rehabilitation Centre. RESULTS: Of all participants, 63.5% were found to be overweight or obese, while 11.5% were underweight. Using the MNA-SF1, 57.7% were found to be at risk of malnourishment while 11.5% were malnourished. More patients were identified to be at risk of malnutrition or to be actually malnourished using the MNA-SF2 (59.6% and 23.1%, respectively). Reported feeding problems included difficulties in maintaining a sitting position, manipulating food on a plate, conveying food to the mouth, and in swallowing. The presence of infections worsened the prognoses of malnourished women regardless of their weight status. CONCLUSIONS: Our findings suggest that MNA-SF2 is a more sensitive tool for identifying malnourishment than MNA-SF1. Obesity can obscure the identification of malnourished patients if clinicians rely solely on the MNA-SF1, which uses the body mass index.

Inulin effects on bioavailability of soy isoflavones and their calcium absorption enhancing ability.

The effect of inulin on isoflavone absorption and the effect of isoflavones and synergy with inulin on calcium absorption in rats was investigated. Rats (n = 48) were divided into three groups and fed inulin (50 mg/g), isoflavone (8 mg/g) or inulin + isoflavone (50 mg/g + 8 mg/g) diets for 21 days. After a 2-h fast, rats were given (45)Ca orally or intraperitoneally, together with 25 mg of calcium as calcium acetate. Blood and femurs were collected 4 days later. Sera were analyzed for isoflavones using HPLC-MS, femurs for (45)Ca by beta-scintillation counting, and total femoral calcium by atomic absorption spectroscopy. Both groups fed isoflavones had similar and significantly higher weight-adjusted total femoral calcium content compared to the inulin-fed group (p < 0.0001). (45)Ca absorption was significantly higher (p < 0.01) when isoflavones were added to the diet, and serum equol was significantly lower (p < 0.01) when inulin was added to the diet containing isoflavones. We conclude that isoflavones enhance calcium absorption, without synergy from inulin, and that inulin decreases equol production.

Whey protein sweetened beverages reduce glycemic and appetite responses and food intake in young females.

We hypothesized that whey protein (WP) will reduce the blood glucose spike, increase satiety, and reduce subsequent energy intake. The objective of the current study was to investigate WP-glucose mixed drinks relative to glucose or WP alone on glycemic response, appetite and energy intake (EI). In Experiment 1 sweetened beverages of 300-mL solution were given to 12 normal-weight females once a week after an overnight fast at 50 g or 75 g glucose, 25 g WP or 25 g WP with 50 g glucose. In Experiment 2 similar beverages were given to 15 normal-weight and 15 overweight females at 25 g glucose, 25 g WP alone or with 25 g glucose. Blood glucose and appetite were measured simultaneously at 0, 15, 30, 45, 60, 90, 120, 150 and 180 minutes in Experiment 1 and at the same time points but up to 120 minutes in Experiment 2. EI was calculated from a meal served at 180 minutes in Experiment 1. The blood glucose spike and hypoglycemia were reduced after WP and WP supplemented glucose in both normal-weight and overweight subjects resulting in smaller incremental area under the curves compared to the pure glucose (P < .05). EI was reduced after both WP drinks with or without glucose (P < .05). Changes in appetite and blood glucose at 180 minutes and blood glucose area under the curves were associated with EI. In conclusion, WP sweetened beverages attenuated blood glucose and appetite in both normal-weight and overweight females and reduced EI in normal-weight females at a 25 g level.

Protein source, quantity, and time of consumption determine the effect of proteins on short-term food intake in young men.

The objective of these 4 studies was to describe the effects of protein source, time of consumption, quantity, and composition of protein preloads on food intake in young men. Young men were fed isolates of whey, soy protein, or egg albumen in sweet and flavored beverages (400 mL) and provided a pizza meal 1-2 h later. Compared with the water control, preloads (45-50 g) of whey and soy protein, but not egg albumen, suppressed food intake at a pizza meal consumed 1 h later. Meal energy intake after egg albumen and soy, but not after control or whey treatments, was greater when the treatments were given in the late morning (1100 h) compared with earlier (0830-0910 h). Suppression of food intake after whey protein, consumed as either the intact protein or as peptides, extended to 2 h. Altering the composition of the soy preload (50 g) by reducing the soy protein content to 25 g and by adding 25 g of either glucose or amylose led to a loss in suppression of food intake by the preload. Egg albumen, in contrast to whey and soy preloads, increased cumulative energy intake (sum of the energy content of the preload plus that in the test meal) relative to the control. We conclude that protein source, time of consumption, quantity, and composition are all factors determining the effect of protein preloads on short-term food intake in young men.

Nondigestible oligosaccharides increase calcium absorption and suppress bone resorption in ovariectomized rats.

Nondigestible oligosaccharides (NDO) including inulin and fructooligosaccharides (FOS) have been reported to stimulate calcium absorption. Here we report the effect of a mixture of inulin and FOS (Raftilose Synergy 1, Orafti) on calcium and bone metabolism in ovariectomized (OVX) rats. OVX rats (6 mo old) were fed a semipurified diet for 3 mo in our animal care laboratory for stabilization after ovariectomy. They were then divided into two groups (n = 13/group) and fed either a control or a NDO-supplemented diet (55 g/kg) for 21 d. Catheters were placed in their jugular veins. After 2 d, a tracer ((45)Ca) was administered by gavage or i.v. and blood was sampled for up to 300 min. Urine and fecal samples were collected for 4 d after (45)Ca administration. Femurs were measured for bone mineral density (BMD), breaking strength, and total calcium. Calcium absorption, femoral calcium content, BMD, and bone balance (V(bal)) were significantly increased (P < 0.05) by NDO, whereas the bone resorption rate relative to the bone formation rate was significantly depressed by NDO. We conclude that feeding NDO at 5.5 g/100 g for 21 d has a positive effect on calcium absorption and retention in ovariectomized rats.