The potential of fermentation on nutritional and technological improvement of cereal and legume flours: A review.

Nowadays there is an increasing demand for vegetable protein sources as an alternative to that of animal origin, not only for its greater environmental sustainability but also for its relationship with lower risk of suffering cardiovascular diseases. Legumes, cereals and seeds are seen as a good proteinaceous source providing as well dietetic fiber and phytochemicals with antioxidant properties. However, their digestibility and bioavailability are limited by the presence of anti-nutritional factors (ANFs) but susceptible of being improved by soaking, cooking or fermentation. The objective of this work is to review the solid-state and submerged fermentation effect on nutritional and functional properties of legumes, cereals and seeds. The microorganisms involved (bacteria, fungus and yeasts) are able to produce enzymes that degrade ANFs giving rise to more digestible flours with a more interesting nutritional, sensorial and technological profile. Solid-state fermentation is more commonly used for its higher efficiency, accepting agro-industrial residues as substrates and its lower volume of effluents. Fermented legumes had their technological properties enhanced while an increment in antioxidant properties was characteristic of cereals. The present review highlights fermentation of cereals and legumes mainly as a key process that at industrial scale could generate new products with enhanced nutritional and technological properties.

Use of a mobile application for self-management of pancreatic enzyme replacement therapy is associated with improved gastro-intestinal related quality of life in children with Cystic Fibrosis.

BACKGROUND: Most patients with cystic fibrosis (CF) suffer from pancreatic insufficiency (PI), leading to fat malabsorption, malnutrition, abdominal discomfort and impaired growth. Pancreatic enzyme replacement therapy (PERT) is effective, but evidence based guidelines for dose adjustment are lacking. A mobile app for self-management of PERT was developed in the context of the HORIZON 2020 project MyCyFAPP. It contains an algorithm to calculate individual PERT-doses for optimal fat digestion, based on in vitro and in vivo studies carried out in the same project. In addition, the app includes a symptoms diary, educational material, and it is linked to a web tool allowing health care professionals to evaluate patient's data and provide feedback. METHODS: A 6-month open label prospective multicenter interventional clinical trial was performed to assess effects of using the app on gastro-intestinal related quality of life (GI QOL), measured by the CF-PedsQL-GI (shortened, CF specific version of the Pediatric Quality of Life Inventory, Gastrointestinal Symptoms Module). RESULTS: One hundred and seventy-one patients with CF and PI between 2 and 18 years were recruited at 6 European CF centers. Self-reported CF-PedsQL-GI improved significantly from month 0 (M0) (84.3, 76.4-90.3) to month 6 (M6) (89.4, 80.35-93.5) (p< 0.0001). Similar improvements were reported by parents. Lower baseline CF-PedsQL-GI was associated with a greater improvement at M6 (p < 0.001). CONCLUSIONS: The results suggest that the MyCyFAPP may improve GI QOL for children with CF. This tool may help patients to improve self-management of PERT, especially those with considerable GI symptoms.