Reducing Dietary Acid With Fruit and Vegetables Versus Oral Alkali in People With Chronic Kidney Disease (ReDACKD): A Clinical Research Protocol.

Background: Individuals with chronic kidney disease (CKD) can develop metabolic acidosis which, in turn, is associated with faster progression of CKD and an increased need for dialysis. Oral sodium bicarbonate (the current standard of care therapy for metabolic acidosis) is poorly tolerated leading to low adherence. Base-producing or alkalizing Fruit and vegetables have potential as an alternative treatment for metabolic acidosis as they have been shown to reduce acid load arising from the diet. Objective: This trial will evaluate the feasibility of providing base-producing fruit and vegetables as a dietary treatment for metabolic acidosis, compared with oral sodium bicarbonate. Design: A 2-arm, open-label, dual-center, randomized controlled feasibility trial. Setting: Two Canadian sites: a nephrology clinic in Winnipeg, Manitoba, and a nephrology clinic in Halifax, Nova Scotia. Participants: Adult participants with G3-G5 CKD and metabolic acidosis. Measurements: Participants will undergo baseline measurements and attend 5 study visits over 12 months at which they will have a measurement of feasibility criteria as well as blood pressure, blood and urine biochemistry, 5-repetition chair stand test (STS5), and questionnaires to assess quality of life and symptoms. Furthermore, participants fill out Automated Self-Administered 24-hour recalls (ASA-24) in the beginning, middle, and end of trial. Methods: A total of 40 eligible participants will be randomized 1:1 to either base-producing fruit and vegetables (experimental) group or sodium bicarbonate (control) group, beginning from a daily dose of 1500 mg. Limitations: Using self-administered dietary assessments, lack of supervision over the consumption of study treatments and the possible disappointment of the control group for not receiving fruit and vegetables would be considered as limitations for this study. However, we are planning to undertake proper practices to overcome the possible limitations. These practices are discussed throughout the article in detail. Conclusions: This study will generate data on base-producing fruit and vegetables consumption as a dietary treatment for metabolic acidosis in CKD. The data will be used to design a future multi-center trial looking at slowing CKD progression in people with metabolic acidosis. Trial Registration: This study is registered on clinicaltrials.gov with the identifier NCT05113641.

Contexte: Les personnes atteintes d'insuffisance rénale chronique (IRC) courent le risque de développer une acidose métabolique, laquelle est associée à une progression plus rapide de l'IRC et à un besoin accru de dialyse. La prise de bicarbonate de sodium par voie orale (la norme actuelle de traitement de l'acidose métabolique) est mal tolérée, ce qui se traduit par une faible adhérence. Les fruit et légumes basiques ou alcalifiants ont un potentiel de traitement alternatif pour l'acidose métabolique, car il a été démontré qu'ils peuvent réduire la charge acide provenant de l'alimentation. Objectif: cet essai permettra d'évaluer la faisabilité d'un traitement alimentaire de l'acidose métabolique, en misant sur la consommation de fruit et légumes basiques ou alcalifiants, par rapport à la prise de bicarbonate de sodium par voie orale. Type d'étude: essai de faisabilité contrôlé, randomisé, ouvert, à deux bras, mené dans deux centres. Cadre: deux sites canadiens, soit une clinique de néphrologie à Winnipeg (Manitoba) et une autre à Halifax (Nouvelle-Écosse). Sujets: des patients adultes atteints d'IRC de stade G3-G5 et d'acidose métabolique. Mesures: les participants seront soumis à des mesures initiales et devront se présenter à cinq visites d'étude réparties sur 12 mois. Au cours de chacune, les patients subiront une mesure des critères de faisabilité, une mesure de la pression artérielle, un bilan sanguin et urinaire, un test de lever de chaise à cinq répétitions (STS5 ­ Five Times Sit to Stand Test) et devront répondre à des questionnaires évaluant la qualité de vie et les symptômes. Les participants devront également utiliser un outil en ligne de rappels alimentaires de 24 heures autoadministrés et automatisés (ASA24 ­ Automated Self-Administered 24-hours) au début, à mi-parcours et à la fin de l'essai. Méthodologie: 40 patients admissibles seront randomisés (1:1) dans le groupe expérimental (fruit et légumes basiques ou alcalifiants) ou dans le groupe témoin (bicarbonate de sodium) avec une dose quotidienne initiale de 1 500 mg. Limites: l'utilisation d'outils d'évaluation alimentaire autoadministrés, le manque de supervision de la consommation des traitements à l'étude et la possible déception du groupe témoin de ne pas recevoir de fruit et légumes constituent des limites pour cette étude. Nous prévoyons cependant adopter des pratiques appropriées pour surmonter ces possibles limites. Ces pratiques sont discutées plus en détail dans le manuscrit. Conclusion: cette étude produira des données sur la consommation de fruit et légumes basiques ou alcalifiants comme traitement alimentaire pour l'acidose métabolique en contexte d'IRC. Ces données seront utilisées pour concevoir un futur essai multicentrique visant à ralentir la progression de l'IRC chez les personnes atteintes d'acidose métabolique. Enregistrement de l'essai: Cette étude a reçu l'approbation du Conseil d'éthique de la recherche en santé de l'Université du Manitoba (HS24768 [B2021:025]) et est enregistrée sur ClinicalTrials.gov avec l'identifiant NCT05113641.

Restricting diet for perceived health benefit: A mixed-methods exploration of peripartum food taboos in rural Cambodia.

Food taboos encompass food restrictions practiced by a group that go beyond individual preferences. During pregnancy and lactation, food taboos may contribute to inadequate nutrition and poor maternal and infant health. Restriction of specific fish, meat, fruits and vegetables is common among peripartum women in many Southeast Asian countries, but data from Cambodia are lacking. In this mixed-methods study, 335 Cambodian mothers were asked open-ended questions regarding dietary behaviours during pregnancy and up to 24 weeks postpartum. Descriptive statistics and content analysis were used to characterize food taboos and multiple logistic regression analyses were conducted to identify predictors of this practice. Participants were 18-44 years of age, all of Khmer ethnicity and 31% were primiparous. Sixty-six per cent of women followed food taboos during the first 2 weeks postpartum, whereas ~20% of women restricted foods during other peripartum periods. Pregnancy taboos were often beneficial, including avoidance of sugar-sweetened beverages, coffee and alcohol. Conversely, postpartum avoidances typically included nutrient-dense foods such as fish, raw vegetables and chicken. Food taboos were generally followed to support maternal and child health. No significant predictors of food taboos during pregnancy were identified. Postpartum, each additional live birth a woman had reduced her odds of following food taboos by 24% (odds ratio [95% confidence interval]: 0.76 [0.61-0.95]). Specific food taboo practices and rationales varied greatly between women, suggesting that food taboos are shaped less by a strict belief system within the Khmer culture and more by individual or household understandings of food and health during pregnancy and postpartum.

Food proteins in the regulation of blood glucose control.

Food proteins, depending on their origin, possess unique characteristics that regulate blood glucose via multiple physiological mechanisms, including the insulinotropic effects of amino acids, the activation of incretins, and slowing gastric emptying rate. The strategies aimed at curbing high blood glucose are important in preventing impaired blood glucose control, including insulin resistance, prediabetes and diabetes. The effect of proteins on blood glucose control can be achieved with high-protein foods short-term, and high-protein diets long-term using foods that are naturally high in protein, such as dairy, meat, soy and pulses, or by formulating high-protein functional food products using protein concentrates and isolates, or blended mixtures of proteins from different sources. Commercial sources of protein powders are represented by proteins and hydrolysates of caseins, whey proteins and their fractions, egg whites, soy, yellow pea and hemp which will be reviewed in this chapter. The effective doses of food protein that are capable of reducing postprandial glycemia start from 7 to 10g and higher per serving; however, the origin of protein, and macronutrient composition of a meal will determine the magnitude and duration of their effect on glycemia. The theoretical and methodological framework to evaluate the effect of foods, including food proteins, on postprandial glycemia for substantiation of health claims on food has been proposed in Canada and is discussed in the context of global efforts to harmonize the international food regulation and labeling.

Age and Sex Interact to Determine the Effects of Commonly Consumed Dairy Products on Postmeal Glycemia, Satiety, and Later Meal Food Intake in Adults.

BACKGROUND: Dairy consumption reduces postprandial glycemia and appetite when consumed with carbohydrates. OBJECTIVES: The objective was to test the effects of frequently consumed dairy products, age, and sex on glycemia, appetite, and food intake. METHODS: In a randomized, unblinded, crossover design, 30 older [60-70 y; BMI (kg/m2): 18.5-29.9] and 28 young (20-30 y; BMI: 18.5-24.9) adults consumed 500 mL of a calorie-free control (water), skim milk and whole milk, 350 g Greek yogurt, and 60 g cheddar cheese. Food intake at an ad libitum meal was measured 120 min later. Glycemia, appetite, and gastric hormone responses were measured premeal (15-120 min), within-meal (120-140 min), and postmeal (140-170 min). Effects of treatment, age, and sex and their interactions were analyzed using ANOVA followed by Tukey's post hoc test. RESULTS: All forms of dairy, compared with water, decreased postmeal glycemia, premeal appetite, and meal intake (P < 0.0001). Premeal glucose, insulin, and glucagon-like peptide 1 increased, and ghrelin decreased, but effects of dairy differed with age and sex. Older adults had 10% higher pre- and postmeal glucose (P < 0.01). Premeal appetite suppression per 100 kcal of treatments was more after yogurt than other dairy, but overall appetite suppression was less in older adults than in young adults and in males than in females (P < 0.05). Pizza intake was reduced by 175 kcal after yogurt and cheese and by 82 kcal after milks compared to water (P < 0.001). Mealtime reduction for treatment calories averaged 62% after yogurt and cheese but was less at 33% after milks (P < 0.05). Compensation was less in older (33%) than in young (63%) adults (P < 0.03). CONCLUSIONS: Dairy products consumed in usual forms before a meal stimulate metabolic responses leading to reduced premeal appetite, later food intake, and postmeal glycemia, but their effects differ in magnitude and with the sex and age of adults.

The effect of dairy products and non-dairy snacks on food intake, subjective appetite and cortisol levels in children: a randomized control study.

Dairy snacks are available in various physical forms and their consumption is linked to improved metabolic health. The objective of this study was to determine the effect of dairy snacks of different physical forms on short-term food intake (FI), subjective appetite, and the stress hormone, cortisol, in children. Following a repeated-measures crossover design, 40 children aged 9-14 years randomly consumed 1 of 5 isoenergetic (180 kcal) snacks per study session. These snacks included solid (potato chips, cookies, and cheese), semi-solid (Greek yogurt), and fluid (2% fat milk) snacks. FI was measured 120 min after snack consumption. Subjective appetite was measured at 0 (immediately before the snack), 15, 30, 45, 60, 90, and 120 min. Salivary cortisol (n = 18) was measured after the Greek yogurt and cookie snacks at 0, 30, 60, 90, and 120 min. FI did not differ between snacks (P = 0.15). The Greek yogurt (P < 0.0001) and cheese (P = 0.0009) snacks reduced average appetite compared with the 2% fat milk snack. Salivary cortisol levels were not affected by snack (P = 0.84). This study demonstrates that dairy snacks are as effective as other popular snacks at influencing subsequent FI. However, solid and semi-solid dairy snacks are more effective at repressing subjective appetite than a fluid dairy snack. Registered at ClinicalTrials.gov (NCT02484625). Novelty: Milk, Greek yogurt and cheese have a similar effect on short-term food intake in children as popular potato chips and cookie snacks. Solid, semi-solid and liquid snacks have a similar effect on short-term food intake in children.

Knowledge and Perceptions of Carbohydrates among Nutrition-Major and Nutrition-Elective Undergraduate Students in Canada.

Objective: The purpose of the study was to assess knowledge and perceptions related to carbohydrates, including sugars, among Canadian nutrition-major undergraduates compared to those enrolled in elective nutrition courses (i.e., "nutrition-elective students").Methods: Cross-sectional surveys were distributed during class time at eight Canadian universities, which included 32 questions on demographics, knowledge and perceptions of carbohydrates and sugars. Descriptive analyses were performed. Differences between groups were tested by Chi-squared statistics.Results: A total of 1207 students (60% nutrition-majors) participated in the survey (January 2016-February 2017). Internet-based sources accounted for one-third of the sources where students obtained nutrition information. About 61% of internet-bases sources were "online" or "website" with no qualifiers, and about a quarter was from social media. A higher percentage of nutrition-majors correctly answered knowledge questions of carbohydrates compared with nutrition-elective students (p < 0.01); no difference was observed for sugars-related knowledge questions. The perceptions of sugars were generally negative and did not differ between groups.Conclusions: Several knowledge gaps and common perceptions on topics related to carbohydrates and sugars were identified; nutrition-major students performed better than nutrition-elective students on carbohydrate knowledge questions, but not sugars. These results highlight the importance of identifying methods to help students bridge knowledge gaps and develop skills to critically evaluate nutrition information from various resources and challenge personal biases.

Effects of cultured dairy and nondairy products added to breakfast cereals on blood glucose control, satiation, satiety, and short-term food intake in young women.

Breakfast cereals are often consumed with dairy products or nondairy alternatives; however, the effect of the combination on blood glucose and food intake control is not well investigated. In a randomized, crossover study, 24 healthy women (age: 22.7 ± 2.5 years; body mass index: 22.1 ± 1.5 kg/m2) consumed, to satiation, 1 of 3 treatments: Greek yogurt with granola (150 kcal, 9.2 g protein, 2.6 g fat, 2.0 g dietary fibre, and 21.5 g available carbohydrate/100 g); cultured coconut product with granola (146 kcal, 3.2 g protein, 3.2 g fat, 5.6 g dietary fibre, and 21.9 g available carbohydrate/100 g); or water control. The data were analyzed with repeated-measures ANOVA. The 2 h blood glucose iAUC was 52% lower after the dairy compared with nondairy treatment (P < 0.0001). While there were no differences in food intake between the caloric treatments consumed to satiation, protein intake was 3 times higher and fibre intake was 4 times lower after the dairy compared with nondairy treatment. Both caloric treatments resulted in similar suppression of ad libitum food intake at 2 h (P < 0.003) and subjective appetite over 2 h (P < 0.0001) compared with water. The cumulative food intake over 2 h was lower after water (P < 0.05). The 1.8-fold increase in postprandial insulin after dairy compared with nondairy treatment may explain the reduction in blood glucose without an increase in subsequent energy intake. Novelty Blood glucose in young females is lower after a breakfast with granola in a high-protein cultured dairy than when in a high-fibre nondairy cultured product. Subjective appetite over 2 h and food intake 2 h later was similarly lower after both breakfasts but cumulative intake was higher compared with breakfast skipping.

Role of single serving form of dairy on satiety and postprandial glycaemia in young and older healthy adults.

Dairy proteins reduce appetite and improve postprandial glycaemic response in adults. However, there are no reports of dairy in amounts usually consumed on satiety and postprandial glycaemia in either young or older adults. In a randomized crossover design, 30 healthy young adults (age: 23.5 ± 0.5 years; body mass index (BMI): 21.8 ± 0.4 kg/m2) and 30 healthy/overweight older adults (age: 65.2 ± 0.5 years; BMI: 24.7 ± 0.6 kg/m2) consumed 1 serving (according to manufacturers' labels) of skim milk (0.1% milk fat (MF)), whole milk (3.25% MF), plain Greek yogurt (2% MF), cheddar cheese (31% MF), and water (energy-free control) after a 12-h fast. Subjective appetite was measured every 15-30 min over 3 h. Blood glucose and insulin were measured at baseline and every 15-30 min over 2 h. All dairy treatments reduced post-treatment subjective appetite area under the curve (AUC) over 3 h by 8%-17% more than water. Greek yogurt reduced appetite 3-h AUC more than skim and whole milk by 9% and 7%, respectively (p < 0.0001). Post-treatment blood glucose 2-h AUC was 42% lower in young compared with older adults (p = 0.003). It was also 52%-78% lower after cheese compared with milks and yogurt (p < 0.0001). Post-treatment insulin AUC after cheese was only 10%-15% of that after milks and Greek yogurt (p < 0.0001). We conclude that single servings of dairy differ in effect on postprandial satiety and glycaemia and merit consideration in management of metabolic syndrome.

Effect of dairy and nondairy snacks on postprandial blood glucose regulation in 9-14-year-old children.

In adults, dairy consumption improves short-term blood glucose regulation. It is unknown if these short-term benefits extend to children of different weight statuses. The objective of this study was to investigate the effect of a dairy and nondairy snack in both normal-weight (NW) and overweight/obese (OW/OB) children on blood glucose regulation and food intake (FI). In a repeated-measures crossover design, 11 NW and 7 OW/OB children (age: 9-14 years), consumed, in random order, a dairy (Greek yogurt, 198.9 g, 171 kcal, 0 g fat, 17 g protein) or nondairy (mini sandwich-type cookies, 37.5 g, 175 kcal, 7.5 g fat, 1.3 g protein) snack containing 25 g of available carbohydrates. Ad libitum FI was measured 120 min after snack consumption. Blood glucose, insulin, C-peptide, and glucagon-like peptide-1 (GLP-1) were measured at 0 min (before the snack), and at 30, 60, 90, and 120 min after snack consumption. Insulin secretion was calculated from deconvolution of C-peptide. Hepatic insulin extraction was calculated as C-peptide divided by insulin. FI did not differ between snacks (P = 0.55). Mean blood glucose was lower (P < 0.001) and insulin higher (P < 0.0001) in the 120 min after consuming the dairy snack. C-Peptide concentrations (P = 0.75) and insulin secretion (P = 0.37) were not different between snacks. The increase in insulin was explained by reduced hepatic insulin extraction (P < 0.01). Consumption of the dairy snack also increased mean GLP-1 concentrations (P < 0.001). In conclusion, consumption of a dairy snack by NW and OW/OB children results in reduced postprandial blood glucose concentrations and elevated circulating insulin compared with a nondairy snack possibly because of delayed hepatic insulin extraction.

Effect of Commercially Available Sugar-Sweetened Beverages on Subjective Appetite and Short-Term Food Intake in Boys.

It is unclear whether sugar sweetened beverages bypass regulatory controls of food intake (FI) in boys. The objective of the present study was to determine the effects of isovolumetric preloads (350 mL) of a fruit-flavoured drink (154 kcal), cola (158 kcal), 1% M.F. chocolate milk (224 kcal), and water (0 kcal) on subjective appetite and FI in boys aged 9⁻14 years. On four separate mornings, boys consumed one of the preloads in a random order; subjective appetite was measured at 15 min intervals, and FI was measured via an ad libitum pizza lunch at 60 min post-beverage consumption. In the 32 boys (age: 11.8 ± 0.3 years), FI was reduced (p < 0.001) after cola (940 ± 46 kcal) and chocolate milk (878 ± 41 kcal) compared with the water control (1048 ± 35 kcal) and after chocolate milk compared to the fruit drink (1005 ± 44 kcal). Cumulative FI after the fruit drink was greater than the water control (1159 ± 44 vs. 1048 ± 35 kcal; p = 0.03). Average appetite was not affected by the treatment, but the cola treatment resulted in greater fullness (p = 0.04) and lower prospective food consumption (p = 0.004) compared with the fruit drink. In conclusion, chocolate milk and cola suppressed next-meal FI at 60 min, while fruit drink increased cumulative FI (beverage + next meal) over 60 min in boys. Results from this study suggest that beverage composition is an important determinant of FI suppression in boys.

Effect of video game playing and a glucose preload on subjective appetite, subjective emotions, and food intake in overweight and obese boys.

Video game playing (VGP) is associated with overweight/obesity (OW/OB). VGP and caloric preloads in the pre-meal environment influence short-term food intake (FI) in healthy-weight children. Therefore, the purpose of the present study was to examine the effect of pre-meal VGP and a glucose preload on subjective emotions, subjective appetite, and FI in boys with OW/OB. On 4 separate mornings, boys with OW/OB (n = 22; mean ± SD: age = 11.9 ± 1.6 years; body mass index percentile = 94.3 ± 3.9) participated in 4 test conditions. Two hours after a standardized breakfast, boys consumed equally sweetened preloads (250 mL) of sucralose (0 kcal) or glucose (200 kcal), with or without 30 min of subsequent VGP. Immediately after each test condition, FI was evaluated during an ad libitum pizza meal. Subjective appetite was measured at 0 (baseline), 15, and 30 min. Subjective emotions (aggression, anger, excitement, disappointment, happiness, upset, and frustration) were measured at 0 and 30 min. VGP did not affect FI, but the glucose preload decreased FI compared with the sucralose control (Δ = -103 ± 48 kcal, p < 0.01). However, cumulative FI (preload kcal + meal kcal) was 9% higher after the glucose preload (p < 0.01). Subjective appetite increased with time (p < 0.05) but was not influenced by preload or VGP. Frustration was the only subjective emotion that increased following VGP (p < 0.01). A glucose preload, but not VGP, suppressed FI in boys with OW/OB, suggesting a primary role of physiological factors in short-term FI regulation.

The effect of dairy and nondairy beverages consumed with high glycemic cereal on subjective appetite, food intake, and postprandial glycemia in young adults.

The objective was to compare the effect of dairy and nondairy beverages when consumed with carbohydrate at breakfast on subjective appetite, food intake (FI), and postprandial glycemia (PPG) in healthy young adults. Twenty-six healthy males and females (13 males and 13 females; 23.0 ± 2.6 years; BMI: 22.3 ± 1.5 kg/m2) participated in a randomized crossover study. They consumed nonisocaloric amounts (250 mL) of almond beverage, soy beverage, 1% fat milk, yogurt beverage, and water (control) with cereal and 120 min later, an ad libitum meal. Subjective appetite, PPG, and insulin were measured at baseline and at intervals before and after the meal at which FI was measured. Post-treatment blood glucose was lowest following soy beverage compared with all treatments but was not different from milk (p = 0.0002). There were no differences between any other treatments. However, over the first hour, PPG for all treatments was 27% lower compared with water (p < 0.0001). Milk and yogurt beverage led to the highest insulin concentrations post-treatment (p < 0.0001) but there were no differences between treatments postmeal. All treatments reduced appetite and led to lower FI at the meal compared with water, but FI was lower after milk compared with all treatments except yogurt beverage (p < 0.0001). Both dairy and nondairy beverages consumed with a high glycemic cereal at breakfast increased satiety and decreased FI compared with water with cereal. Despite higher carbohydrate content, all beverages led to similar or lower PPG than the water breakfast, but dairy beverages increased insulin more than nondairy beverages.

The effect of dairy products consumed with high glycemic carbohydrate on subjective appetite, food intake, and postprandial glycemia in older adults.

The objective was to compare the effect of liquid, semi-solid, and solid dairy products and a nondairy beverage when consumed with glycemic carbohydrate on subjective appetite, food intake (FI), and post-prandial glycemia (PPG) in healthy older adults. Thirty healthy men and women (14 males and 16 females; age: 64.6 ± 2.4 y; BMI: 25.6 ± 2.5 kg/m2) participated in a randomized crossover study. Treatments were one of 250 mL of 2% fat milk and soy beverage, 175 g of 2% Greek yogurt, and 30 g of Cheddar cheese consumed as part of an isocaloric (380 kcal) meal with bread and jam. Water alone served as the energy-free control for subjective appetite. At 180 min after consumption, the participants were fed an ad libitum meal to measure FI. Subjective appetite, blood glucose, and insulin were measured at baseline and at intervals both before (post-treatment) and after the meal (postmeal). Cheese and yogurt resulted in lower post-treatment blood glucose than milk and soy beverage when consumed with carbohydrate (p < 0.0001), but no differences among any treatments were observed postmeal. Treatments led to similar insulin concentrations. Post-treatment appetite was lower than after the water control for all treatments but suppressed more by cheese and yogurt compared with milk (p < 0.0001). There were no differences in FI among treatments. Cheese and yogurt increase satiety and lower PPG more than milk or a soy beverage when consumed with carbohydrate.

Pre- and within-meal effects of fluid dairy products on appetite, food intake, glycemia, and regulatory hormones in children.

The effect of beverages commonly consumed by children in-between or with meals on short-term food intake (FI) and glycemic control has received little attention. Therefore, 2 experiments were conducted in 9- to 14-year-old children following a randomized repeated-measures design. Experiment 1 (n = 32) compared the effects of water (control) and isocaloric (130 kcal) amounts of 2% milk, chocolate milk, yogurt drink, and fruit punch on subjective appetite and FI. Experiment 2 (n = 20) compared the effects of isocaloric (130 kcal) amounts of 2% milk and fruit punch on subjective appetite, FI, and glycemic and appetite hormone responses. One serving of the beverages was given as a pre-meal drink at baseline (0 min) and a second serving 60 min later with an ad libitum pizza meal. Meal FI in experiment 1 was lower by 14% and 10%, respectively, after chocolate milk and yogurt drink (p < 0.001), but not milk, compared with water. Cumulative energy intake (beverages plus meal) was higher after caloric beverages than water. In experiment 2, no differences occurred in pre-meal but post-meal glucose was 83% higher in overweight/obese than normal-weight children (p = 0.02). Milk led to higher pre-meal glucagon-like peptide-1 and post-meal peptide tyrosine tyrosine (PYY) than fruit punch (p < 0.01) but insulin did not differ between treatments. In conclusion, dairy products consumed before and with a meal have more favourable effects on FI, appetite, and satiety hormones than a sugar-sweetened beverage, but all caloric beverages result in more cumulative calories than if water is the beverage.

Canned Navy Bean Consumption Reduces Metabolic Risk Factors Associated with Obesity.

The high prevalence of obesity and its metabolic co-morbidities require dietitians to promote lifestyle modifications that can be effectively implemented into practice and are feasible for customers to adhere to. The objective of this study was to determine the effect of commercially available ready-to-eat canned navy beans added to the habitual diet on risk factors associated with obesity. Fourteen overweight and obese adults consumed 5 cups of canned navy beans per week for 4 weeks. The study results demonstrated that bean consumption results in reduced waist circumference in females by 2.5 cm and males by 2.1 cm (P < 0.001). The effect of beans on pulse rate, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) were sex dependent (P < 0.05). In males, pulse rate, TC, and LDL were decreased by 6.5%, 11.5%, and 18%, respectively. In females, pulse rate increased by 9.6%, and TC and LDL were relatively unchanged. There was a trend for a decreased glucose AUC (P = 0.06) in response to a glucose load. This study demonstrates that consuming 5 cups per week of ready-to-eat canned navy beans for 4 weeks reduces metabolic risk factors associated with obesity and therefore can be used as a tool in dietetic practice.

Interaction of mealtime ad libitum beverage and food intake with meal advancement in healthy young men and women.

The objective of this study was to describe the interaction of beverage and food intake with meal advancement in healthy adults. In a randomized controlled study, 29 men and women consumed to satiation, over 20 min, a pizza meal with one of the five beverages including water, 1% milk, orange juice, regular cola and diet cola. Mealtime food and fluid intake were measured, within each of three 7-min phases of the meal. A progressive decline occurred from phase 1 to 3 in fluid intake and food intake, averaging 59 mL and 268 kcal (P < 0.0001) respectively; however, the relative intake of fluid to food (mL/kcal) increased (P < 0.0001). Beverage type was not a factor. All beverages resulted in similar fluid volume intake compared to water. However, caloric beverages led to higher mealtime total energy intake compared to water (P < 0.001) and diet cola (P < 0.0001). Baseline thirst correlated positively with both fluid (r = 0.28; P < 0.001) and food (r = 0.16; P < 0.05) intakes at the meal, whereas baseline appetite associated positively only with mealtime food intake (r = 0.23; P<0.01). In conclusion, mealtime fluid and food intakes interact, unaffected by beverage characteristics, to increase the ratio of fluid to food intake with meal progression.

Mealtime exposure to food advertisements while watching television increases food intake in overweight and obese girls but has a paradoxical effect in boys.

Food advertisements (ads) in TV programs influence food choice and have been associated with higher energy intake from snacks in children; however, their effects at mealtime have not been reported. Therefore, we measured energy intake at a pizza meal consumed by normal weight (NW) and overweight/obese (OW/OB) children (aged 9-14 years) while they watched a TV program with or without food ads and following pre-meal consumption of a sweetened beverage with or without calories. NW and OW/OB boys (experiment 1, n = 27) and girls (experiment 2, n = 23) were randomly assigned to consume equally sweetened drinks containing glucose (1.0 g/kg body weight) or sucralose (control). Food intake was measured 30 min later while children watched a program containing food or nonfood ads. Appetite was measured before (0-30 min) and after (60 min) the meal. Both boys and girls reduced energy intake at the meal in compensation for energy in the glucose beverage (p < 0.05). Food ads resulted in further compensation (51%) in boys but not in girls. Food ads increased energy intake at the meal (9%; p = 0.03) in OW/OB girls only. In conclusion, the effects of TV programs with food ads on mealtime energy intake and response to pre-meal energy consumption in children differ by sex and body mass index.

The effects of whole grain high-amylose maize flour as a source of resistant starch on blood glucose, satiety, and food intake in young men.

The objective of this study was to determine the dose response effect of whole grain high-amylose maize (HAM) flour as a source of resistant starch (RS) on blood glucose, appetite and short-term food intake. In a repeated-measures crossover trial, healthy men (n = 30, 22.9 ± 0.6 y, BMI of 22.6 ± 0.3 kg/m(2)) were randomly assigned to consume 1 of 3 cookies once a week for 3 wk. Cookies were control (100% wheat flour), low-dose (63% wheat flour,37% HAM flour), and high-dose (33% wheat flour, 67% HAM flour) providing 53.5, 43.5, and 36.3 g of available carbohydrate, respectively. Ad libitum food intake was measured 120 min at a pizza meal, blood glucose and subjective appetite were measured after consumption of the cookie (0 to 120 min) and after the pizza meal (140 to 200 min). Blood glucose concentrations were lower at 30 and 45 min after high-dose treatment, and at 120 min after both high- and low-dose treatments compared to control (P < 0.05). Blood glucose AUC before the pizza meal (0 to 120 min) was 44% and 14% lower, and higher by 43% and 41% after the pizza meal (140 to 200 min) compared with control. Yet despite the higher response following the meal, cumulative AUC (0 to 200 min) was still 22% lower after the high-dose treatment (P < 0.05). All treatments equally suppressed subjective appetite and there was no effect on food intake. In conclusion, HAM flour as a source of RS and incorporated into a cookie was associated with better glycemic control in young men.

Acute effects of pea protein and hull fibre alone and combined on blood glucose, appetite, and food intake in healthy young men--a randomized crossover trial.

Whether pulse components can be used as value-added ingredients in foods formulated for blood glucose (BG) and food intake (FI) control requires investigation. The objective of this study was to examine of the effects of pea components on FI at an ad libitum meal, as well as appetite and BG responses before and after the meal. In a repeated-measures crossover trial, men (n = 15) randomly consumed (i) pea hull fibre (7 g), (ii) pea protein (10 g), (iii) pea protein (10 g) plus hull fibre (7 g), (iv) yellow peas (406 g), and (v) control. Pea hull fibre and protein were served with tomato sauce and noodles, while yellow peas were served with tomato sauce. Control was noodles and tomato sauce. FI was measured at a pizza meal (135 min). Appetite and BG were measured pre-pizza (0-135 min) and post-pizza (155-215 min). Protein plus fibre and yellow peas led to lower pre-pizza BG area under the curve compared with fibre and control. At 30 min, BG was lower after protein plus fibre and yellow peas compared with fibre and control, whereas at 45 and 75 min, protein plus fibre and yellow peas led to lower BG compared with fibre (p < 0.05). Following the pizza meal (155 min), yellow peas led to lower BG compared with fibre (p < 0.05). No differences were observed in FI or appetite. This trial supports the use of pea components as value-added ingredients in foods designed to improve glycemic control.