Salt-related knowledge, attitudes, and practices and their relationship with 24-hour urinary sodium and potassium excretions among a group of healthy residents in the UAE: A cross-sectional study.

OBJECTIVE: This study aimed to measure urinary sodium and potassium as a measure of sodium and potassium intake concerning the knowledge, attitude, and practice (KAP) toward sodium intake among a group of healthy residents in the UAE. DESIGN: A cross-sectional study on a sample of healthy adults in the UAE. In addition to the KAP questionnaire, sodium and potassium excretions, and food records were taken. SETTING: The United Arab Emirates. PARTICIPANTS: A sample of 190 healthy individuals aged between 20-60 years. RESULTS: The mean (± SD) age of the sample was 38.6 (± 12.5) years and 50.5% were females. The mean urinary sodium and potassium intake were 2816.2± 675.7 mg /day and 2533.3± 615 mg/day, respectively. The means were significantly different compared to the World Health Organization (WHO) recommendation of sodium and potassium, (p < 0.001). About 65% of the participants exceeded the WHO recommendations for salt intake, and participants' knowledge classification for health-related issues was fair while food-related knowledge was poor (P=0.001). A two-stage stepwise multiple regression analysis revealed that KAP scores were negatively associated with urinary sodium excretion (r = -0.174; p = 0.017) and those older participants and females had lower urinary sodium excretion (p<0.001). CONCLUSION: These findings may suggest an increase in the risk of hypertension in the UAE population. Moreover, these findings emphasize the need to establish education and public awareness programs focusing on identifying the sodium contents of foods and establishing national regulations regarding food reformulation, particularly for staple foods such as bread.

The effect of high-polyphenol sumac (Rhus coriaria) on food intake using sensory and appetite analysis in younger and older adults: A randomized controlled trial.

Aging is accompanied by a decline in appetite and food intake with associated deficiencies in both macronutrients and micronutrients. The aim of this study was to investigate the impact of adding Iranian brown sumac (Rhus coriaria) (CIBS) into butternut squash soup on sensory evaluation and food intake among older adults (n = 20; >65 years old) and younger adults (n = 20; 18-35 years old). To evaluate the polyphenol content and antioxidant activity of the sumac samples, a Folin-Ciocalteu assay (FCR) and ferric ion reducing antioxidant power (FRAP) assay were used, respectively. L-glutamic acid was assessed using a Megazyme L-glutamic acid assay. Compusense software was used to assess the sensory evaluation attributes of free-living older adults and younger adults receiving different doses of sumac in butternut squash soup. Nutritics software was used to assess food intake following the addition of 0.37 g of sumac to soup. CIBS was selected based on a preliminary assessment in vitro for L-glutamic acid, antioxidant, and polyphenol content of six varieties of sumac. Sensory evaluation results revealed that the difference in perceived intensity of brown color between the soup samples with different doses of CIBS was greater in the younger adults' group (p = .001) than in older adults (p = .037). In addition, the food intake study found that during the ad libitum lunch, older adults consumed more energy (kcal; p = .014), protein (g; p = .025), carbohydrate (g; p = .013), and fat (g; p = .002) after soup with sumac compared to control soup. The overall findings of this study suggest that the addition of sumac to food may have a potential benefit in enhancing ad libitum lunch intake in older adults leading to effective management of malnutrition. This may promote healthy aging and minimize the burden and the consequences of anorexia of aging as main public health concerns.

Using Digital Platform Approach to Reduce Salt Intake in a Sample of UAE Population: An Intervention Study.

Background: Non-communicable diseases (NCDs) are the leading causes of mortality globally, accounting for more deaths than all other causes combined. World Health Organization launched its initiative in 2013 to reduce the intake of salt, the number of countries that have national sodium reduction strategies reached to 89 countries in 2017. In 2020, a study conducted in UAE showed more than 65% of the population exceeded WHO recommendations for salt intake. This study aimed to measure effectiveness of using digital platform approach to deliver educational materials to facilitate salt reduction in a sample of UAE population. Methods: A controlled parallel intervention study was conducted in 2020. A sample of 121 participants completed the study and fulfilled the inclusion criteria with female to male ratio of (0.95:1.05). Participants were distributed randomly into three groups Control group, WhatsApp group, and Electronic Brochures group. Educational materials were distributed among participants of WhatsApp and Electronic brochures groups for 6-weeks. 24-h urinary excretion for sodium, potassium and creatinine, were measured in addition to KAP questionnaire and physical activity on two occasions at baseline and endpoint after 10-weeks (6-weeks of educational intervention). Results: Both intervention groups showed a reduction in sodium with 278 mg (p < 0.001) for WhatsApp group (n = 41) and 169 mg (p < 0.018) for Electronic brochures group (n = 41), while Control group didn't show any significant change. Moreover, the percentage of participants exceeding WHO recommendation of sodium intake was significantly reduced at the end of intervention, (p = 0.004). WhatsApp group was more efficient in the percentage of reduction of participants exceeding WHO recommendation compared with baseline, with p = 0.023. A significant reduction in the practice toward adding salt during cooking, use of table salt, adding salt before tasting the foods and use of chicken stocks for both intervention groups was noted with p < 0.05. Intervention groups showed a significant improvement (p < 0.001) in Food and Health related knowledge after 6-weeks of intervention. Conclusion: The digital platform approach such as WhatsApp and Electronic Brochure were effective in salt reduction. This study proves that UAE population is ready to reduce salt intake with appropriate education materials and easy delivery approach.

Finger millet-based muffin decreases insulin response in individuals with prediabetes in a randomised controlled trial.

Millet is a grain high in polyphenols and antioxidants, which are bioactive compounds known to influence blood glucose response. The aim of this study was to compare the effect of finger millet muffin and wheat muffin on glycaemic response (GR), insulin response (IR), gastric emptying (GE) and satiety in healthy individuals and people with prediabetes. In a single-blind randomised controlled crossover trial at Oxford Brookes Centre for Nutrition and Health, fifteen healthy individuals and fourteen individuals with prediabetes were recruited between May and December 2017. The participants' GR (3 h), IR (3 h), GE (4 h) and satiety (4 h) were measured before and after the consumption of muffins. A mixed method ANOVA was used to compare GE and the incremental AUC (iAUC) for GR and IR between the participant groups and muffins. There was a significant interaction between participants and muffins on IR iAUC at 180 min (P = 0·042). A significant effect of muffins was found on the GR peak (P = 0·013). The millet muffin decreased the GR peak and IR iAUC compared with the wheat muffin in participants with prediabetes. A significant interaction between participants and muffins for GE ascension time Tasc (P = 0·017) was observed, with no effect of muffins on satiety AUC in the participant groups. This study suggested that polyphenol and fibre-rich finger millet may have the potential to influence the management of prediabetes.

Diet and nutrition in patients who have received pelvic radiotherapy: A mixed-methods study to explore dietary habits, nutritional awareness, and experiences of nutritional care.

OBJECTIVES: Individuals who have survived cancer may benefit from dietary modifications to improve quality of life and future health outcomes. The aim of this study was to explore dietary habits and experiences of nutritional support in patients with a cancer diagnosis who have received radiotherapy to the pelvic area. METHODS: A mixed-methods approach was used. Individuals diagnosed with a pelvic cancer (anal, bladder, rectal, and cancers of the reproductive organs), either undergoing or having completed pelvic radiotherapy 6 to 24 mo previously, were invited to participate in a postal survey. A purposive subsample was also invited to take part in telephone interviews. Thematic analysis of interview data was undertaken and integrated with data from quantitative analysis. RESULTS: The survey was completed by 254 (38%) respondents. Two-thirds of respondents (170) reported dietary changes since diagnosis; most notable changes were reduction of sugary foods (48%) and alcohol (41%). Receipt of support from the health care team was significantly associated with dietary change (odds ratio, 3.26; 95% confidence interval, 1.58-6.75); however, only 43% (108) had received dietary support from the health care team. Of the respondents, 68% (171) said they would like to receive additional dietary support. The effect of the condition on diet was highlighted in the theme "Impact of diagnosis and treatments on dietary choices." Self-management of disease was influenced by personal resources, social resources, comorbidities and disabilities, influence of work, regaining normality, and barriers to dietary changes. CONCLUSION: Lack of routine provision of nutritional care to patients after a cancer diagnosis and patient interest in this area highlighted unmet needs in managing diet-related problems and leading a healthy future lifestyle.

Mulberry leaf extract improves glycaemic response and insulaemic response to sucrose in healthy subjects: results of a randomized, double blind, placebo-controlled study.

BACKGROUND: There are many benefits of maintaining healthy blood glucose levels, and studies have shown that lifestyle changes such as changes to diet can successfully restore normoglycaemia in participants with dysglycaemia. Significant health-related lifestyle changes are often difficult to implement and functional ingredients that can reduce glycaemic and insulaemic responses may help at risk populations. The aim of this study was to investigate whether a mulberry leaf extract could lower the glycaemic and insulinaemic responses to 75 g sucrose in healthy individuals. METHODS: A double-blind, randomised, placebo-controlled, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health. Thirty-eight participants were recruited into the trial and, after an overnight fast, were given 75 g sucrose + white mulberry leaf extract, or 75 g sucrose alone. Capillary blood samples were collected at 15-min intervals in the first hour and at 30-min intervals over the second hour to determine glucose and plasma insulin levels. Data analysis was conducted using a paired samples T test or a Wilcoxon signed rank test. RESULTS: The addition of mulberry leaf extract to sucrose resulted in a significantly lower glycaemic response and insulinaemic response compared to a matched placebo (sucrose alone). The change in blood glucose measurements were significantly lower at 15 min (p < 0.001), 30 min (p < 0.001), 45 min (p = 0.008), and 120 min (p < 0.001) and plasma insulin measurements were significantly lower at 15 min (p < 0.001), 30 min (p < 0.001), 45 min (p < 0.001), 60 min (p = 0.001) and 120 min (p < 0.001). The glucose iAUC (- 42%, p = 0.001), insulin iAUC (- 40%, p < 0.001), peak glucose (- 40.0%, p < 0.001) and peak insulin (- 41%, p < 0.001) from baseline were significantly lower for white mulberry leaf extract compared with the placebo. White mulberry leaf extract was well tolerated and there were no reported adverse events. CONCLUSIONS: Mulberry leaf extract can be used as part of lifestyle changes that may lead to healthy blood glucose levels. TRIAL REGISTRATION: ISRCTN99601810 (23 October 2020, retrospectively registered).

Co-ingestion of NUTRALYS® pea protein and a high-carbohydrate beverage influences the glycaemic, insulinaemic, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) responses: preliminary results of a randomised controlled trial.

PURPOSE: Plant-based proteins may have the potential to improve glycaemic and gastrointestinal hormone responses to foods and beverages. The aim of this study was to investigate the effect of two doses of pea protein on postprandial glycaemic, insulinaemic, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) response following a high-carbohydrate beverage intake in healthy individuals. METHODS: In a single-blind, randomised, controlled, repeat measure, crossover design trial, thirty-one participants were randomly assigned to ingest 50 g glucose (Control), 50 g glucose with 25 g pea protein (Test 1) and 50 g glucose with 50 g pea protein (Test 2) on three separate days. Capillary blood samples (blood glucose and plasma insulin measurements) and venous blood samples (GIP and GLP-1 concentrations) were taken before each test and at fixed intervals for 180 min. The data were compared using repeated-measures ANOVA or the Friedman test. RESULTS: Glucose incremental Area under the Curve (iAUC180) was significantly lower (p < 0.001) after Test 2 compared with Control (- 53%), after Test 1 compared with Control (- 31%) and after Test 2 compared with Test 1 (-32%). Insulin iAUC 180 was significantly higher (p < 0.001) for Test 1 (+ 28%) and Test 2 (+ 40%) compared with Control and for Test 2 (+ 17%) compared with Test 1 (p = 0.003). GIP and GLP-1 release showed no clear difference between Control and Pea protein drinks. CONCLUSION: The consumption of pea protein reduced postprandial glycaemia and stimulated insulin release in healthy adults with a dose-response effect, supporting its role in regulating glycaemic and insulinaemic responses.

The effect of a split portion of flaxseed on 24-h blood glucose response.

PURPOSE: Flaxseed can be effective at lowering and stabilising blood glucose responses. The aim of this study was to determine whether flaxseed could lower blood glucose response more effectively when consumed as a single portion of 30 g, or a split portion consumed three times per day (10 g flaxseed per portion). METHODS: The study was a randomised, repeated measures, cross-over design. Fifteen healthy participants consumed either (1) three flaxseed muffins containing a total of 30 g of flaxseed once in the morning, (2) three flaxseed muffins consumed at three different timepoints across the day (10 g flaxseed per muffin) or (3) three control muffins consumed at three different timepoints across the day (0 g flaxseed). The 24-h blood glucose response was measured using a continuous glucose monitor. RESULTS: The results of this study demonstrated that flaxseed muffins given three times a day were effective at lowering and maintaining blood glucose levels over 24 h, compared to the control muffins and that both flaxseed treatments resulting in a lower blood glucose iAUC during the night. CONCLUSION: The results of this study indicated that adding flaxseed to a daily diet produced a lower glucose profile over 24 h in a free-living context compared to the control muffins.

Reply to "Comparisons of Within-Group Instead of Between-Group Affect the Conclusions. Comment on: Changes in Weight and Substrate Oxidation in Overweight Adults Following Isomaltulose Intake during a 12-Week Weight Loss Intervention: A Randomized, Double-Blind, Controlled Trial. Nutrients 2019, 11(10), 2367".

We thank the authors Vorland, Kyle and Brown for their interest in our paper and their comments [...].

Diet and nutrition information and support needs in pelvic radiotherapy: A systematic, mixed-methods review.

INTRODUCTION: This study aimed to review diet and nutrition information and support needs of cancer patients who receive pelvic radiotherapy to inform the development of interventions to improve this area of care. METHODS: The systematic review followed the PRISMA guidelines. Six electronic databases were searched for peer-reviewed studies of any design that assessed diet and nutrition needs after a pelvic cancer diagnosis. Narrative synthesis was used to integrate findings. RESULTS: Thirty studies (12 quantitative, 15 qualitative, 3 mixed-methods) were included. Four themes, "content of dietary information"; "sources of information"; "sustaining dietary change"; and "views on the role of diet post-treatment," summarised evidence about provision of nutritional guidance following diagnosis, but also contrasting views about the role of diet post-diagnosis. Qualitative studies contributed considerably more to the synthesis, compared to quantitative studies. Included studies were of moderate to good quality; selection bias in quantitative studies and poor evidence of credibility and dependability in qualitative studies were highlighted. CONCLUSION: There is some evidence of lack of nutrition support in pelvic cancer survivors, but methodological limitations of included studies may have had an impact on the findings. Future, prospective studies that focus on diet and nutrition needs post-diagnosis are warranted to improve care.

Changes in Weight and Substrate Oxidation in Overweight Adults Following Isomaltulose Intake During a 12-Week Weight Loss Intervention: A Randomized, Double-Blind, Controlled Trial.

Low-glycemic compared to high-glycemic diets have been shown to improve metabolic status and enhance fat oxidation. The randomized, double-blind, controlled intervention study aimed to evaluate the effects of an energy-reduced diet containing isomaltulose (ISO, Palatinose™) versus sucrose (SUC) on body weight loss. Sixty-four healthy overweight/obese adults were allocated to consume either 40g/d ISO or SUC added to an energy-reduced diet for 12 weeks. Anthropometric measurements, body composition, and energy metabolism were assessed at baseline and after 4, 8, and 12 weeks. Fifty participants (age: 40.7 ± 11.7 y; BMI: 29.4 ± 2.7 kg/m²) completed the study. During the 12 weeks, both groups significantly lost weight (p < 0.001), which was more pronounced following ISO (-3.2 ± 2.9 vs. -2.1 ± 2.6 kg; p = 0.258). Moreover, for participants in the ISO group, this was accompanied by a significant reduction in fat mass (ISO: -1.9 ± 2.5, p = 0.005; SUC: -0.9 ± 2.6%, p = 0.224). The overall decrease in energy intake was significantly higher in the ISO compared to that in the SUC group (p = 0.022). In addition, breakfast containing ISO induced a significantly lower increase in postprandial respiratory quotient (RQ) (mean incremental area under the curve (iAUC)2h for ISO vs. SUC: 4.8 ± 4.1 vs. 6.9 ± 3.1, p = 0.047). The results suggest that ISO in exchange for SUC may help to facilitate body weight reduction, lower postprandial RQ associated with higher fat oxidation, and reduce energy intake.

Availability and quality assessment of online nutrition information materials for pelvic cancer patients in the UK.

OBJECTIVE: Written information can be an essential source of support in the promotion of lifestyle changes after a cancer diagnosis. This study aimed to identify and assess the quality of available online patient information materials (PIMs) in relation to diet and nutrition for patients with pelvic cancer. METHODS: The online sources of the National Health Service, cancer centres and charitable organisations throughout the UK were searched. Content was assessed using an evidence-based checklist, and readability with two validated formulas. Consumer feedback was sought through patient and public involvement (PPI) groups. RESULTS: Forty PIMs were identified; four were designed specifically for pelvic cancers (bladder, bowel, prostate) and 36 were generic (relevant for all cancers). Most PIMs had a good content score, with PIMs from charities scoring higher overall than PIMs from cancer centres [32 (4) vs. 23 (11), p < 0.001]. Seventy-three percent of PIMs had a readability score within acceptable levels (6th-8th grade; reading ability of 11-14 year-olds). PPI contributors found most PIMs useful and comprehensive but lacking specific information needed to meet individual needs. CONCLUSION: There is limited availability of online PIMs for cancer survivors and even fewer tailored to pelvic cancers. Most materials have comprehensive content and acceptable readability. Some PIMs may require improvement.

The Effect of Consuming a Liquid Diet vs a Solid Diet 24-hr Preexperimental Trials on Adherence in Athletes.

Discrepancies in energy and macronutrient intakes between tests are apparent even when a solid prepackaged diet (Sdiet) is used to standardize dietary intake for preexperimental trials. It is unknown whether a liquid prepackaged diet (Ldiet) leads to improved adherence, resulting in lower variability in energy and macronutrient intakes. This study assesses the ability of athletes to replicate a diet when an Ldiet or Sdiet was used as a dietary standardization technique. In a cross-over design, 30 athletes were randomly assigned to either Sdiet or Ldiet. Each diet was consumed for two nonconsecutive days. Participants were instructed to consume all the meals provided and to return any leftovers. The coefficient of variation (CV) was calculated for each nutrient for the two methods and reported as the average CV. The Bland-Altman plots show that differences between Days 1 and 2 in energy and macronutrient intakes for both diets were close to zero, with the exception of some outliers. The %CV for Sdiet was higher than Ldiet (5% and 3% for energy, 5% and 3% for carbohydrate, 5% and 2% for protein, and 5% and 3% for fat, respectively). There was a strong positive correlation for energy and all macronutrients between Days 1 and 2 for both methods (r > .80; p < .05). Ldiet is an effective technique to standardize diet preexperimental trials and could be used as an alternative to Sdiet. Furthermore, Ldiet may lead to additional improvements in the compliance of participants to the diet and also decrease the cost and time of preparation.

Glycaemic index, glycaemic load and dietary fibre characteristics of two commercially available fruit smoothies.

In light of the updated Eatwell Guide and the corresponding change in the consumption of fruit smoothies, the aim of this study was to measure the glycaemic index and load of two commercial fruit smoothies and to investigate the retention of dietary fibre following production. In vitro analysis was performed to identify fibre material (cellulose and pectins) using calcofluor staining and immunocytochemical labelling. A repeated measures cross-over study was conducted (n 10) to determine the glycaemic index (GI) and glycaemic load (GL) of the smoothies. Results showed that dietary fibre was still present in the smoothies after processing (16.9-17.5% cellular material by dry weight). The GI was low for both smoothies (39 and 36), whereas the GL was medium and borderline-low, respectively (11.4 and 9.7). The retention of fibre in these smoothies may have a potential positive effect on glycaemic response and may contribute to daily fibre requirements.

Replacement of glycaemic carbohydrates by inulin-type fructans from chicory (oligofructose, inulin) reduces the postprandial blood glucose and insulin response to foods: report of two double-blind, randomized, controlled trials.

PURPOSE: Inulin-type fructans are recognized as prebiotic dietary fibres and classified as non-digestible carbohydrates that do not contribute to glycaemia. The aim of the present studies was to investigate the glycaemic response (GR) and insulinaemic response (IR) to foods in which sucrose was partially replaced by inulin or oligofructose from chicory. METHODS: In a double-blind, randomized, controlled cross-over design, 40-42 healthy adults consumed a yogurt drink containing oligofructose or fruit jelly containing inulin and the respective full-sugar variants. Capillary blood glucose and insulin were measured in fasted participants and at 15, 30, 45, 60, 90, and 120 min after starting to drink/eat. For each test food, the incremental area under the curve (iAUC) for glucose and insulin was calculated and the GR and IR determined. RESULTS: Consumption of a yogurt drink with oligofructose which was 20% reduced in sugars significantly lowered the glycaemic response compared to the full-sugar reference (iAUC120min 31.9 and 37.3 mmol/L/min, respectively; p < 0.05). A fruit jelly made with inulin and containing 30% less sugars than the full-sugar variant likewise resulted in a significantly reduced blood glucose response (iAUC120min 53.7 and 63.7 mmol/L/min, respectively; p < 0.05). In both studies, the postprandial insulin response was lowered in parallel (p < 0.05). The reduction of postprandial glycaemia was positively correlated to the proportion of sugars replaced by inulin-type fructans (p < 0.001). CONCLUSIONS: In conclusion, the studies confirmed that substitution of glycaemic sugars by inulin or oligofructose from chicory may be an effective strategy to reduce the postprandial blood glucose response to foods.

Mulberry-extract improves glucose tolerance and decreases insulin concentrations in normoglycaemic adults: Results of a randomised double-blind placebo-controlled study.

BACKGROUND: High sugar and refined carbohydrate intake is associated with weight gain, increased incidence of diabetes and is linked with increased cardiovascular mortality. Reducing the health impact of poor quality carbohydrate intake is a public health priority. Reducose, a proprietary mulberry leaf extract (ME), may reduce blood glucose responses following dietary carbohydrate intake by reducing absorption of glucose from the gut. METHODS: A double-blind, randomised, repeat measure, phase 2 crossover design was used to study the glycaemic and insulinaemic response to one reference product and three test products at the Functional Food Centre, Oxford Brooks University, UK. Participants; 37 adults aged 19-59 years with a BMI ≥ 20kg/m2 and ≤ 30kg/m2. The objective was to determine the effect of three doses of mulberry-extract (Reducose) versus placebo on blood glucose and insulin responses when co-administered with 50g maltodextrin in normoglycaemic healthy adults. We also report the gastrointestinal tolerability of the mulberry extract. RESULTS: Thirty-seven participants completed the study: The difference in the positive Incremental Area Under the Curve (pIAUC) (glucose (mmol / L x h)) for half, normal and double dose ME compared with placebo was -6.1% (-18.2%, 5.9%; p = 0.316), -14.0% (-26.0%, -2.0%; p = 0.022) and -22.0% (-33.9%, -10.0%; p<0.001) respectively. The difference in the pIAUC (insulin (mIU / L x h)) for half, normal and double dose ME compared with placebo was -9.7% (-25.8%, 6.3%; p = 0.234), -23.8% (-39.9%, -7.8%; p = 0.004) and -24.7% (-40.8%, -8.6%; p = 0.003) respectively. There were no statistically significant differences between any of the 4 groups in the odds of experiencing one or more gastrointestinal symptoms (nausea, abdominal cramping, distension or flatulence). CONCLUSIONS: Mulberry leaf extract significantly reduces total blood glucose rise after ingestion of maltodextrin over 120 minutes. The pattern of effect demonstrates a classical dose response curve with significant effects over placebo. Importantly, total insulin rises were also significantly suppressed over the same time-period. There were no statistically significant differences between any of the treatment groups (including placebo) in the odds of experiencing one or more gastrointestinal symptoms. Mulberry extract may have multiple modes of action and further studies are necessary to evaluate ME as a potential target for the prevention of type 2 diabetes and the regulation of dysglycaemia.

Changes in PYY and gastric emptying across the phases of the menstrual cycle and the influence of the ovarian hormones.

Nutrition-related studies avoid the participation of pre-menopausal women due to the potential effect of the menstrual cycle (MC) on their appetite regulation. It is generally accepted that women increase their energy intake during the luteal phase (LPh) compared to the follicular (FPh), however what happens in the menstrual phase (MPh) and how this might be regulated remains uncertain. Although some research indicates changes in the gastric emptying (GE) velocity, whether PYY is affected by the MC phase, remains unknown. The aim of this study was to assess whether eating the same breakfast in each of the three MC phases would change the GE time, the PYY response and post-prandial satiety such that they might affect subsequent food intake. Furthermore, the aim was to associate any potential differences to the fluctuations in estradiol (E2) and progesterone (P4) within a MC. Nine naturally cycling women attended to the laboratory to consume a standardised breakfast on three occasions, each of them representing one of the MC phases. Breath samples to measure GE time, plasma samples to quantify PYY levels and hunger scores were collected for a total of 4 h after which food intake was assessed by an ad-libitum buffet lunch. GE and PYY levels changed significantly across the phases of the MC (p < 0.05). GE was correlated to P4 and E2-P4 ratio (r = -0.5 and 0.4, respectively). To conclude, the appetite regulators PYY and GE time change depending upon the MC phases with GE time associated with the ovarian hormone levels which suggests the necessity of controlling the MC phase in studies looking at the appetite response.

Mulberry extract to modULate Blood glucosE Responses in noRmoglYcaemic adults (MULBERRY): study protocol for a randomised controlled trial.

BACKGROUND: Worldwide sugar consumption has tripled during the last fifty years. High sugar intake is associated with weight gain and increased incidence of diabetes and has been linked with increased cardiovascular mortality. Reducing the health impact of dietary sugar and poor quality carbohydrate intake is a public health priority. IminoNorm®, a proprietary mulberry leaf extract (ME), may reduce blood glucose responses following dietary sugar and carbohydrate intake by reducing absorption of glucose from the gut. Previous research has shown that ME can reduce blood glucose and improve insulin responses in healthy subjects and also in subjects with raised fasting blood glucose levels. Mulberry leaf has an excellent safety profile. This pilot study will test a novel, safe, water soluble product in normoglycaemic adults in the UK to determine if it can reduce glucose absorption without increasing plasma insulin concentration. METHODS/DESIGN: The trial will be a double-blind, individually randomised, four-arm single-dose crossover design to test the effect of three doses of ME in order to determine efficacy, dose response relationship and gastrointestinal side effects with respect to placebo. A total of 40 subjects will participate in this study and attend for four visits receiving each of the four interventions in random order. DISCUSSION: We aim to test the evidence that mulberry leaf extract can reduce blood glucose without a disproportionate increase in blood insulin responses in healthy individuals in a high-quality research study based in the UK. It is hoped that this will lead to further randomised controlled trials and an effective dietary supplement to lower blood glucose concentrations. ISRCTN: ISRCTN14597438 (21 April 2015).

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.