Behavioral Activation for Comorbid Depression in People With Noncommunicable Disease in India: Protocol for a Randomized Controlled Feasibility Trial.

BACKGROUND: The increasing burden of depression and noncommunicable disease (NCD) is a global challenge, especially in low- and middle-income countries, considering the resource constraints and lack of trained human resources in these settings. Effective treatment of depression in people with NCDs has the potential to enhance both the mental and physical well-being of this population. It will also result in the effective use of the available health care resources. Brief psychological therapies, such as behavioral activation (BA), are effective for the treatment of depression. BA has not been adapted in the community health care services of India, and the feasibility of using BA as an intervention for depression in NCD and its effectiveness in these settings have not been systematically evaluated. OBJECTIVE: Our objective is to adapt BA for the Indian NCD context and test the acceptability, feasibility, and implementation of the adapted BA intervention (BEACON intervention package [BIP]). Additionally, we aim to test the feasibility of a randomized controlled trial evaluation of BIP for the treatment of depression compared with enhanced usual care. METHODS: Following well-established frameworks for intervention adaptation, we first adapted BA (to fit the linguistic, cultural, and resource context) for delivery in India. The intervention was also adapted for potential remote delivery by telephone. In a randomized controlled trial, we will be testing the acceptability, feasibility, and implementation of the adapted BA intervention (BIP). We shall also test if a randomized controlled feasibility trial can be delivered effectively and estimate important parameters (eg, recruitment and retention rates and completeness of follow-up) needed to design a future definitive trial. RESULTS: Following the receipt of approval from all the relevant agencies, the development of the BIP was started on November 28, 2020, and completed on August 18, 2021, and the quantitative data collection was started on August 23, 2021, and completed on December 10, 2021. Process evaluation (qualitative data) collection is ongoing. Both the qualitative and quantitative data analyses are ongoing. CONCLUSIONS: This study may offer insights that could help in closing the gap in the treatment of common mental illness, particularly in nations with limited resources, infrastructure, and systems such as India. To close this gap, BEACON tries to provide BA for depression in NCDs through qualified NCD (BA) counselors integrated within the state-run NCD clinics. The results of this study may aid in understanding whether BA as an intervention is acceptable for the population and how feasible it will be to deliver such interventions for depression in NCD in South Asian countries such as India. The BIP may also be used in the future by Indian community clinics as a brief intervention program. TRIAL REGISTRATION: Clinical Trials Registry of India CTRI/2020/05/025048; https://tinyurl.com/mpt33jv5. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41127.

Effect of Gamma-irradiation on the Physicochemical, Functional, and Antioxidant Properties of Unpigmented Brown Whole Rice Flour.

Whole grain brown rice, being a rich source of fiber and other bioactive compounds like polyphenols is effective in reducing the risk of chronic diseases including cardiovascular diseases, hypercholesterolemia and Type II diabetes. The study was aimed to evaluate the effect of gamma irradiation on the physicochemical, functional and antioxidant properties of whole grain brown rice flour. The brown rice flour was conditioned to two different moisture contents of 10% and 12% and treated with gamma irradiation doses of 0 kGy (native or control), 2.5 kGy and 5 kGy. Moisture, protein, fat, ash and carbohydrate content of native flour was found as 10 g/100 g, 6.54 g/100 g, 1.54 g/100 g, 1.0 g/100 g, and 81.48 g/100 g, respectively. The hunter color 'L', 'a', and 'b' values of the native brown rice flour sample were found as 81.95, -0.97 and 17.36, respectively and were non-significantly (p ≥ 0.05) affected by gamma irradiation. Apparent amylose content was observed to decrease significantly (p ≤ 0.05) from 29.97 to 20.30 g/100 g with the increase in gamma irradiation dose and moisture content. The pasting properties such as peak viscosity, trough viscosity and final viscosity of all the flour samples decreased significantly (p ≤ 0.05) with the increase in irradiation dose. The functional properties such as water and oil absorption and emulsion capacities were increased while emulsion stability and foaming stability decreased upon irradiation. Irradiation led to an overall increase in the antioxidant activity of rice flours. In general, FTIR spectra revealed a decrease in the absorption intensities of the functional groups. Therefore, it can be concluded that gamma irradiation can be used as a tool to modify the physicochemical properties of rice flours as well as to improve their antioxidant properties.

Bioactive characterization of ultrasonicated ginger (Zingiber officinale) and licorice (Glycyrrhiza Glabra) freeze dried extracts.

Ginger (Zingiber officinale) and Licorice (Glycyrrhiza glabra L.) are one of the most popular spices having a wide range of bioactive compounds that have varied biological and pharmacological properties. The study was aimed to extract polyphenols from Himalayan medicinal herbs ginger and licorice in different solvents using ultra-sonication technique. The extraction efficiency (EE) was determined, and the extracts were characterized for physical properties (particle size, colour values), total phenolics, flavonoids, antioxidant properties, and structural and morphological features. Ultra-sonicated ginger in aqueous phase had the highest EE of polyphenols (15.27%) as compared to other solvents. Similar trend was observed in licorice with EE of 30.52 % in aqueous phase followed by ethanol: water (50: 50), and methanol: water (50:50) with 28.52% and 26.39%, respectively. The preliminary screening showed the presence of tannins, phenolics, flavonoids, saponins and carbohydrates, steroids and alkaloids in all the extracts. The phenolic and flavonoid content of dried ginger was found higher in ethanolic extracts compared to fresh ones as revealed by HPLC. Similarly, for licorice, the ethanolic fractions had the highest polyphenolic content. The representative samples of ginger (ethanol: water 75:25 and ethylacetate: water 75:25) and licorice (ethanol: water 70:30 and methanol: water 50:50) were studied for FESEM and particle size. The results showed the agglomerated extract micro-particles with a diameter of 0.5-10 µm and increased particle size (ginger: 547 and 766 nm), and (licorice: 450 and 566 nm). The findings could be beneficial for the advancement of ginger and licorice processing, for the comprehension of these herbs as a source of natural antioxidants in different food formulations.

Pasting, rheology, antioxidant and texture profile of gluten free cookies with added seed gum hydrocolloids.

The study was carried out with the aim of developing gluten free cookies using rice-chickpea composite flour. Guar and locust bean gum were added to formulations at two test concentrations (0.5 and 1.0%). To study the impact of these hydrocolloids, pasting and rheometry of dough formulations was carried out. The cookies produced were subjected to colour, spread ratio, hardness and antioxidant analysis. Protein (7.56 g/100g), fat (1.78 g/100g), ash (1.25 g/100g) and carbohydrate (80.41 g/100g) content of composite flour varied significantly (p ≤ 0.05) from both rice and chickpea. Higher viscosity, viscoelasticity and antioxidant profile was shown by dough formulations with added gums. Control cookies prepared without gums showed the L*, a* and b* values of 54.62, 3.81 and 35.97, respectively. With the addition of guar and locust bean gum, colour of the cookies became lighter. Spread ratio and hardness of cookies with added gums was higher.

Tomato powder and crude lycopene as a source of natural antioxidants in whole wheat flour cookies.

The nutritional quality of bakery products keeps on degrading from the process of baking, packaging, transportation and storage. The present study was carried out to evaluate the effect of addition of tomato powder (2 & 4/100 g of flour) and crude lycopene (50 & 100 mg/100 g of flour), which have potent antioxidant activity, on the nutritional quality and shelf life of cookies prepared from whole wheat flour. Color values i.e., a* and b* of freshly prepared cookies containing tomato powder (TP) were found in the range of 5.40-6.21 and 33.20-33.40 respectively, and that of crude lycopene (CL) in the range of 5.18-5.24 and 32.50-34.90 respectively, higher than the control (4.53 and 32.50, respectively). Significant (p < 0.05) and non-significant (p > 0.05) increase was observed in the total phenolic content of dough containing TP (0.54-0.72 mg GAE/g) and CL (0.46-0.59 mg GAE/g), when compared to control (0.38 mg GAE/g). Antioxidant properties like, DPPH scavenging activity, reducing power and inhibition of lipid peroxidation (ILP), and total carotenoid content (TCC) of dough and cookies increased significantly (p < 0.05) upon incorporation of TP and CL. Sensory properties of enriched cookies were comparable with that of control. Color values (a* and b*), hardness, TCC, ILP and TPC were reduced significantly (p < 0.05) with storage.

Effect of extrusion on the physicochemical and antioxidant properties of value added snacks from whole wheat (Triticum aestivum L.) flour.

Nutritional quality of snacks prepared from cereals can be improved by the addition of crude lycopene (CL), tomato powder (TP) and saffron extracts (SE) which are known for their high photochemical content. The study was undertaken to prepare extruded snacks from whole wheat flour enriched with CL, TP and SE. Effect of extrusion on physicochemical, antioxidant and sensory properties of snacks was also investigated. Hardness of snacks containing CL and TP was higher than the control. Pasting properties of the formulations were significantly (p < 0.05) reduced upon addition of CL and TP. Total phenolic content (TPC) of the formulations with added TP increased significantly (p < 0.05). Antioxidant properties of snacks enhanced after enrichment. Extrusion significantly (p < 0.05) reduced the TPC, DPPH scavenging activity and pasting properties of snacks while, reducing power and inhibition of lipid peroxidation increased. Storage period lowered the hardness and antioxidant properties of snacks.

Effect of guar gum conjugation on functional, antioxidant and antimicrobial activity of egg white lysozyme.

This study was undertaken to analyze the effect of conjugation of egg-white lysozyme with guar gum. Lysozyme is an antimicrobial polypeptide that can be used for food preservation. Its antibacterial activity is limited to gram positive bacteria. Conjugation with polysaccharides like guar gum may broaden its activity against gram negatives. Conjugate was developed through Maillard reaction. Assays carried out included sugar estimation, SDS-PAGE, GPC, color, FT-IR, DSC, thermal stability, solubility, emulsifying, foaming and antioxidant activity. In addition, antimicrobial activity of the conjugate was determined against two gram positive (Staphyllococcus aureus and Enterococcus) and two gram negative pathogens (E. coli and Salmonella). Results showed higher functional properties of lysozyme-guar gum conjugate. The antioxidant properties increased from 2.02-35.80% (Inhibition of DPPH) and 1.65-4.93AAE/g (reducing power) upon guar gum conjugation. Conjugate significantly inhibited gram negative bacteria and the antibacterial activity also increased significantly against gram positive pathogens.