Swapping White for High-Fibre Bread Increases Faecal Abundance of Short-Chain Fatty Acid-Producing Bacteria and Microbiome Diversity: A Randomized, Controlled, Decentralized Trial.

A low-fibre diet leads to gut microbiota imbalance, characterized by low diversity and reduced ability to produce beneficial metabolites, such as short-chain fatty acids (SCFAs). This imbalance is associated with poor gastrointestinal and metabolic health. We aimed to determine whether one dietary change, substitution of white bread with high-fibre bread, improves gut microbiota diversity and SCFA-producing capability. Twenty-two healthy adults completed a two-phase randomized, cross-over trial. The participants consumed three slices of a high-fibre bread (Prebiotic Cape Seed Loaf with BARLEYmax®) or control white bread as part of their usual diet for 2 weeks, with the treatment periods separated by a 4-week washout. High-fibre bread consumption increased total dietary fibre intake to 40 g/d, which was double the amount of fibre consumed at baseline or during the white bread intervention. Compared to white bread, the high-fibre bread intervention resulted in higher faecal alpha diversity (Shannon, p = 0.014) and relative abundance of the Lachnospiracae ND3007 group (p < 0.001, FDR = 0.019) and tended to increase the butyrate-producing capability (p = 0.062). In conclusion, substituting white bread with a high-fibre bread improved the diversity of gut microbiota and specific microbes involved in SCFA production and may enhance the butyrate-producing capability of gut microbiota in healthy adults. These findings suggest that a single dietary change involving high-fibre bread provides a practical way for adults to exceed recommended dietary fibre intake levels that improve gut microbiota composition and support gastrointestinal and metabolic health.

Aortic root motion: a marker of left ventricular diastolic dysfunction using M-mode echocardiography? An observational study.

Echocardiography remains the best non invasive tool for identifying patients who may have impaired filling of the left ventricle or diastolic dysfunction. The most accurate echocardiographic modality that reveals normal and abnormal diastolic function is doppler tissue imaging (DTI), and more recently, strain imaging. The complex and user intense DTI modality traces the motion of the mitral annulus during left ventricular filling revealing diastolic impairment. The aortic annulus with its attached aortic root moves simultaneously with the rigidly attached mitral annulus. M-mode traced motion of the aortic root in diastole mimics the motion of the mitral annulus and thus should depict left ventricular diastolic function. Hypertensive patients and normal subjects were screened for left ventricular diastolic dysfunction (LVDD) with DTI, mitral inflow velocities (MIF) and M-mode aortic root motion (M-MARM). The easily obtained and less complex M-MARM was as accurate as DTI in detecting and ruling out regional

Effect of aspirin on lipoprotein(a) in patients with ischemic stroke.

Hyperlipidemia and increased serum lipoprotein (Lp)(a) are independent risk factors for atherosclerosis and its complications. Serum Lp(a) concentration is not influenced by most lipid-lowering therapies other than niacin. Recently aspirin also has been reported to decrease its levels. In the current study, we evaluated the serum levels of Lp(a) and lipids in 25 patients with first-ever diagnosed ischemic stroke, aged 21 to 60 years, and compared their levels with an equal number of age- and sex-matched healthy control subjects. In addition, the effect of aspirin on Lp(a) levels was studied by estimating its levels after 4 weeks of daily treatment with 150 mg of aspirin. Both groups were comparable regarding their anthropometric measurements and routine laboratory parameters except that erythrocyte sedimentation rate was higher in the patients. Serum lipids were not significantly different between the two groups, although Lp(a) levels were significantly higher in the patients (27.40 +/- 22.30 mg/dL) as compared with the control subjects (14.68 +/- 11.75 mg/dL) (P = .005). Twenty of 25 patients (80%) had serum Lp(a) levels of more than 10 mg/dL, whereas only 11 of 25 control subjects (44%) had serum Lp(a) levels of more than 10 mg/dL (P = .009). After 4 weeks of treatment with aspirin, Lp(a) levels declined significantly (46.24%) from baseline 27.40 +/- 22.30 mg/dL to 14.73 +/- 10.47 mg/dL (P < .001). Patients with baseline levels greater than 25 mg/dL showed greater decline (55.63%) compared with those with levels less than 25 mg/dL (26.63%) (P = .008). Results of our study confirm that aspirin lowers the increased Lp(a) levels in patients with ischemic stroke.

Waist circumference correlates better with body mass index than waist-to-hip ratio in Asian Indians.

BACKGROUND: Waist circumference has been reported to be a better index of android (abdominal) obesity than waist-to-hip ratio. It is likely that the cut-off values that denote medical risk in the Caucasian population cannot be extrapolated to Asian Indians. METHODS: This was a hospital-based, cross-sectional study. Anthropometric measurements were taken in 285 subjects (207 men, mean age 37 years, range 18-76 years; and 78 women, mean age 31.5 years, range 18-69 years). The subjects comprised patients under psychiatric care as well as normal individuals. The correlation of waist circumference, hip circumference and waist-to-hip ratio with body mass Index was studied. The prevalence of abdominal obesity using waist circumference was compared to the prevalence of abdominal obesity using waist-to-hip ratio. (Both the standard and the new recommended cut-offs for Asians were used.) RESULTS: Waist circumference correlated better with body mass index than waist-to-hip ratio (in men r = 0.821 and 0.341, and in women r = 0.729 and 0.113; p < or = 0.01 ). Forty-seven per cent of overweight men and 73% of overweight women had abdominal obesity as defined by the standard waist circumference cut-offs compared to none of the men and 47% of overweight women using the waist-to-hip ratio. CONCLUSION: Waist circumference correlates better with body mass index than waist-to-hip ratio. The prevalence of abdominal obesity using waist circumference is higher than that with waist-to-hip ratio. This is especially so in Asian Indians as the new recommendations of both body mass index and waist circumference cut-offs to detect subjects at medical risk are lower in them than in Caucasians.