Alterations in SAMD9, AHSG, FRG2C, and FGFR4 Genes in a Case of Late-Onset Massive Tumoral Calcinosis.

Background/Objective: Tumoral calcinosis (TC) is a rare, arcane, and debilitating disorder of phosphate metabolism manifesting as hard masses in soft tissues. Primary hyperphosphatemic TC has been shown to be caused by pathogenic variants in the genes encoding FGF23, GALNT3, and KLOTHO. We report a case of massive TC mechanistically associated with phosphatonin resistance associated with heterozygous alterations in the sterile alfa motif domain-containing protein-9 gene (SAMD9), alfa 2-Heremans-Schmid glycoprotein gene (AHSG), FSHD region gene 2-family member-C gene (FRG2C), and fibroblast growth factor receptor-4 gene (FGFR4). Case Report: A middle-aged Malay woman with systemic sclerosis presented with painful hard lumps of her axillae, lower limbs, and external genitalia. She was eucalcemic with mild hyperphosphatemia associated with reduced urinary phosphate excretion. Magnetic resonance imaging revealed calcified soft tissue masses. Paradoxically, the serum intact FGF23 level increased to 89.6 pg/mL, corroborated by Western blots, which also showed overexpression of sFRP4 and MEPE, consistent with phosphatonin resistance. Discussion: Whole genome sequencing identified 2 heterozygous alterations (p.A454T and p.T479M) in SAMD9, 2 heterozygous alterations (p.M248T and p.S256T) in AHSG, a frameshift alteration (p.Arg156fs) in FRG2C, and a heterozygous alteration (p.G388R) in FGFR4, all of which are associated with calcinosis. Nonsynonymous alterations of FRP4 and MEPE were also detected. Conclusion: This highlights that the simultaneous occurrence of alterations in several genes critical in phosphate homeostasis may trigger massive TC despite their heterozygosity. These findings should prompt functional studies in cell and animal models to reveal mechanistic insights in the pathogenesis of such crippling mineralization disorders.

Is mushroom polysaccharide extract a better fat replacer than dried mushroom powder for food applications?

Introduction: ß-glucans found in the cell walls of mushrooms can be a beneficial food additive in replacing fat in commercial food products. Methods: Four commonly consumed mushroom species in Singapore, i.e., Pleurotus ostreatus spp., Lentinus edodes, Agaricus bisporus, and Flammulina velutipes were profiled for the ß-glucan content in the lyophilized form and ultrasonicated assisted extracted form. Both forms were added into chicken patties, which were characterized for the moisture, cooking loss, texture, color, and chemically analyzed for the protein, crude fat, and fatty acid profiles with gas chromatography mass spectrometry (GC-MS). Results and discussion: Pleurotus Ostreatus spp. had the highest ß-glucan of 29.8 ± 0.7 g/100 g in the pure powder form and 15.9 ± 0.3 g/100 g from the extract. Crude fat in 100% fat substituted patties was lowest in Flammulina velutipes extract enriched patties and least in A. bisporus pure powder patties. Additionally, fat replacement with A. bisporus extract and powder forms resulted in the highest polyunsaturated fatty acid profile of 49.6 ± 1.9 mg/100 g patty and 79.9 ± 4.5 mg/100 g patty, respectively. Chicken patties with added mushroom extract were notable in retaining moisture, cooking yield and its structure. Fat substitution with mushroom powder was also conducted, satisfactory results indicated a possibility as a better fat replacer that is easily processed and an efficient alternative to ß-glucan extract. With increasing demand for low fat foods with acceptable organoleptic properties, our study demonstrates that the inclusion of dry mushroom powder has the ability to mimic the "fattiness" of chicken patties.

Almond paste and dietary fibre: a novel way to improve postprandial glucose and lipid profiles?

Asia has become the epicentre of type 2 diabetes (T2D), predominately due to the consumption of carbohydrate-rich and high-glycemic-index (high-GI) diets. Previously, almond consumption has been reported to reduce the risk of T2D, obesity, and related diseases. The hypothesis of this randomised cross-over clinical trial was that almond paste consumption with bread would improve postprandial glycemic and insulinemic responses. Fifteen healthy Chinese men consumed four bread-based meals containing different amounts of almond paste and inulin. Our results show that co-ingesting bread with 15 g of almond paste and 4 g of inulin significantly reduced the postprandial glucose and insulin levels. The corresponding GI value was 44 (low GI), which was lower than the GI value of white bread, which was 60 (medium GI). However, co-ingestion of almond paste with bread increased the postprandial triglyceride levels. Further studies will be required to demonstrate these effects on a long term basis.Clinical trial registration No: NCT05504044.

Carotenoids, tocopherols and phylloquinone content of 26 green leafy vegetables commonly consumed in Southeast Asia.

Carotenoids, tocopherols and phylloquinone are highly valued in vegetables due to their potential health benefits. The profile of eight carotenoids, four tocopherols, and phylloquinone in 26 green leafy vegetables (GLV) commonly consumed in Southeast Asia were analysed by high-performance liquid chromatography with atmospheric pressure chemical ionisation and tandem mass spectrometry (HPLC-APCI-MS/MS). Lutein, ß-carotene and α-tocopherol were the predominant carotenoids and tocopherol in the GLV. Among 26 GLV, sweet leaf bush contained the highest amount of total carotenoids (494 ± 22 µg/g fresh weight (FW)), tocopherols (214 ± 60 µg/g FW) and phylloquinone (18 ± 2 µg/g FW). Other underutilised GLV, including wolfberry leaves, cassava leaves and moringa leaves, are also a rich source of fat-soluble micronutrients. Overall, this study enhanced the understanding of micronutrient composition in underutilised GLV in Southeast Asia. Data will be important for diet recommendations to promote the nutritional status of the population in the region.

Energy Content and Nutrient Profiles of Frequently Consumed Meals in Singapore.

Singapore is a multi-ethnic country with a great variety of traditional ethnic cuisines. In this modern society where there is an increasing prevalence of obesity, it is important to know the nutritional content and energy density of our foods. However, there have been little data on the nutritional content of our local foods. The energy density and nutrient content of 45 commonly consumed meals by three ethnic groups in Singapore (Chinese, Malay, and Indian) were assessed in this study. Chinese, Malay, and Indian cuisines had an average energy density of 661, 652, and 723 kJ/100 g, respectively. Moreover, the macronutrient content is different between the different ethnic groups. Compared to Chinese and Malay cuisines, Indian cuisine contained lower protein but higher fat and carbohydrate content (p = 0.03). From the mineral analysis of the ethnic foods, we found out that Chinese cuisines contain significantly higher sodium (average of 238 mg/100 g) than Malay cuisines (p = 0.006) and Indian cuisines (p = 0.03). Knowing the caloric density and nutrition content of local ethnic foods may aid hawkers and government officials in developing healthier options to tackle Singapore's obesity epidemic.

Development of Fatty Acid Reference Ranges and Relationship with Lipid Biomarkers in Middle-Aged Healthy Singaporean Men and Women.

Dietary fatty acids (FA) are essential for overall human health, yet individual FA reference ranges have yet to be established. Developing individual FA reference ranges can provide context to reported concentrations and whether an individual displays deficient, or excess amounts of FA. Reference ranges of sixty-seven individual FA (µmol/L) were profiled and analyzed using gas chromatography with a flame ionization detector from serum samples collected from 476 middle-aged Singaporean males (BMI:23.3 ± 2.9) and females (BMI:21.8 ± 3.6). Measures of triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol (TC) (mmol/L) were also collected. The mean FA concentration seen in this cohort (11,458 ± 2478 was similar to that of overweight North American cohorts assessed in past studies. Ten biologically relevant FA were compared between sexes, with females exhibiting significantly higher concentrations in four FA (p < 0.05). A multiple regression model revealed the ten FA contributed significantly to nearly all lipid biomarkers (p < 0.05). A majority of participants who had FA concentrations in the ≥95th percentile also exhibited TG, HDL, LDL, and TC levels in the "high" risk classification of developing cardiovascular disease. Future studies profiling individual FA reference ranges in many unique, global cohorts are necessary to develop cut-off values of individual FA concentrations highly related to disease-risk.

Acrylamide Contents of Local Snacks in Singapore.

Acrylamide is a carcinogen that forms in foods processed at high temperatures. In this study, acrylamide contents of 30 local snacks commonly consumed by the three ethnic groups (Malay, Chinese, and Indian) in Singapore were analysed by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). These snacks were chosen because they were consumed regularly by people of different classes and age groups in Singapore. Our results showed that the average content of acrylamide in Indian snacks (102.23 ng/g) was higher than those in Malay (75.14 ng/g) and Chinese snacks (70.78 ng/g). The high acrylamide levels in several snacks was probably due to the processing methods and the usage of acrylamide-inducing raw materials. Same snacks prepared by different manufacturers contained different levels of acrylamide, suggesting the possibility of acrylamide reduction in these snacks. This study provides an insight into the acrylamide levels of snacks commonly consumed by the three different ethnic groups in Singapore.

Energy Density and Nutrient Contents of Selective Chinese New Year Snacks.

BACKGROUND: In this study, the energy density and nutrient contents of thirty Chinese New Year (CNY) snacks commonly consumed in the Asian region during the CNY festive season were measured. METHODS: Calorie Answer™, Gas Chromatography-Mass Spectrometry (GC-MS) and Inductively coupled plasma-mass spectrometry (ICP-MS) were the main methods applied in this study. RESULTS: All snacks showed high energy density (kJ/100 g) and the nutrient content, including macro-and micronutrients of these snacks were remarkably different. The most abundant minerals in these snacks include sodium, magnesium, potassium, and calcium. Palmitic (C16:0), oleic (C18:1) and linoleic (C18:2) acids were the main fatty acids and trans-fat was only identified in Butter cookies. CONCLUSIONS: This study provides a large database on macro- and micronutrient contents in CNY snacks consumed in the Asian region that has not been previously reported. Our results indicate that the snacks were generally energy-dense and nutrient-poor. This study provides necessary information to enable the reformulation of snacks with lower saturated fat and sodium content. It is also a source of information for consumers to select healthier snacks.

Relationships between adiponectin and bone: Sex difference.

OBJECTIVES: Despite being secreted exclusively by adipocytes, circulating adiponectin (ApN) is negatively associated with obesity. Moreover, obesity is traditionally viewed as leading to increased bone mass and density. Therefore, ApN may play a biological role in regulating fat and bone metabolism. The objective of this study is to evaluate the relationship between ApN, measures of obesity, and bone mineral density (BMD) in healthy adults living in Singapore. METHODS: We conducted a cross-sectional study of 300 participants (112 men), and measured body composition (i.e., fat mass, fat-free mass, BMD, and bone mineral content) by dual-energy x-ray absorptiometry. Serum leptin and ApN levels were determined by radioimmunoassay. RESULTS: Our results showed that serum ApN levels were significantly associated with obesity measures in both men and women, and the greater effect was observed in men. In contrast, the relationship between ApN and BMD was sex-dependent. Levels of ApN were negatively associated with BMD in women, but not in men. This relationship persisted even after adjustment for potential confounding factors, such as leptin and body mass index. Moreover, serum ApN was found to be a major determinant of BMD in women on the multivariate regression analysis. CONCLUSIONS: Our results suggest that ApN, an adipocyte-derived hormone, may affect bone metabolism, which may be mediated by sex hormones.

Basal Metabolic Rate and Body Composition Predict Habitual Food and Macronutrient Intakes: Gender Differences.

The underlying mechanisms that regulate energy homeostasis and food intake are not fully understood. Moreover, little research has been performed on the relation of body composition with habitual macronutrient intake among free-living populations. Since body composition and energy metabolism differ between males and females, we aimed to determine whether the relationship between body composition and habitual macronutrient intakes is gender-dependent. In this cross-sectional study, 261 participants (99 males) were recruited from Singapore. Macronutrient intake was evaluated from a three-day self-reported dietary record. Body composition and basal metabolic rate (BMR) were determined by using dual-energy X-ray absorptiometry (DEXA) and indirect calorimetry, respectively. Our results show that both BMR (p < 0.001) and lean body mass (LBM, p < 0.001) predicted daily energy intake (EI). LBM was positively associated with intakes of protein (PRO) and fat (FAT) in females, but not in males. This relationship persisted even after adjustment for fat mass (FM). On the other hand, no significant associations between FM and macronutrient intake were observed in both males and females. Therefore, the relationship between habitual macronutrient intake, LBM, and BMR is gender-dependent. Elucidating the gender differences in energy metabolism is important for understanding the factors that regulate energy homeostasis and can subsequently help better manage energy balance.

Development of an Easy-to-Use Visual Aid for the Prediction of Body Fat Based on Waist Circumference and Height in Asian Chinese Adults.

BACKGROUND: Adiposity is a major risk factor for metabolic and cardiovascular diseases. Initial prediction equations to estimate adiposity are complex, requiring skinfold measurements that cannot be obtained conveniently by the general population. OBJECTIVE: To develop simplified prediction equations to estimate body fat percentage (%BF) in Asian Chinese adults, evaluate the validity of the simplified %BF prediction equations, compare the simplified %BF prediction equations with an existing equation, and create visual charts to enable easy assessment of adiposity by the general public. DESIGN: Simplified prediction equations were developed and evaluated for validity using anthropometric measurements obtained from a cross-sectional study. PARTICIPANTS AND SETTING: Healthy participants with no major diseases and not taking long-term medications were recruited in a cross-sectional study conducted at Clinical Nutrition Research Centre, Singapore, between June 2014 and October 2017. A total of 439 participants were used for model building (269 women and 170 men) and another 107 participants were used for evaluating validity (62 women and 45 men). MAIN OUTCOME MEASURES: Simplified but acceptable prediction models and generation of user-friendly charts. STATISTICAL ANALYSES PERFORMED: Simplified sex-specific %BF prediction equations were developed using stepwise regression and the model-building dataset. The best models were selected using the Akaike information criterion. The models were further simplified and their performance was compared using the validation dataset before choosing the final prediction equations. RESULTS: The final selected models for women and men included waist circumference and height with nonsignificant prediction bias in %BF of 0.84%±3.94% (P=0.098, Cohen's dz=0.21) and -0.98%±3.65% (P=0.079, Cohen's dz=0.27), respectively. The final equations were split into three height categories from which the sex-specific prediction charts were generated. CONCLUSIONS: The sex-specific prediction charts provide a good visual guide for estimating %BF using height and waist circumference values that are easy to obtain by the general public.

Does circulating leptin play a role in energy expenditure?

OBJECTIVES: It has been demonstrated that leptin influences the energy balance by regulating appetite and increasing energy expenditure (EE). However, the relationship between circulating leptin and EE is confounded owing to variations in body composition. The aim of this study was to determine the role of circulating leptin in energy regulation and to examine whether the leptin-mediated changes in EE are associated with adiposity among healthy adults living in Singapore. METHODS: We conducted a cross-sectional study of 300 participants (112 men). Resting metabolic rate (RMR) was measured by indirect calorimetry. Body composition (i.e., fat mass [FM] and fat-free mass [FFM]) was measured by dual-energy x-ray absorptiometry. Serum leptin levels were determined by radioimmunoassay. RESULTS: There were strong correlations between circulating leptin levels, FM, and RMR in healthy men and women. After normalization of RMR by a power function model (kcal·kg FFM0.86·d-1), the influence of FFM can be effectively removed. The normalized RMR was significantly associated with both FM (r = 0.28, P < 0.001) and log leptin (r = 0.35, P < 0.001). In the stepwise multiple regression analysis, leptin level is the major predictor for normalized RMR, accounting for 12% of the variation. In contrast, FM did not explain any variation in normalized RMR. CONCLUSION: Leptin may be a more significant predictor of normalized RMR than FM per se. The contribution of FM to RMR could be via a mechanism that is related to leptin-dependent responses involved in energy homeostasis.

Obesity is an independent determinant of elevated C-reactive protein in healthy women but not men.

BACKGROUND AND AIMS: High-sensitivity C-reactive protein (hs CRP) has emerged as an inflammatory biomarker to predict metabolic syndrome. Here, we investigate the association of hs CRP with metabolic variables and determine the risks for elevated hs CRP levels in healthy Singaporean adults. METHODS: We conducted a cross-sectional study of 225 participants (104 men). The levels of hs CRP and fasting lipid parameters were analyzed by COBAS. Body composition was determined with dual-energy X-ray absorptiometry. RESULTS: Twenty-one (9 %) participants had elevated hs CRP levels (>3 mg/mL). The levels of hs CRP had significant correlations (p <0.05) with obesity and metabolic variables among women. Stepwise multivariate regression analysis identified FM (%) (accounted for 22.5% of the variability in hs CRP levels) as a major determinant of hs CRP levels. On multivariate regression, FM (%) was the independent determinant of intermediate and elevated hs CRP in women after adjustment for the potential confounders. CONCLUSIONS: Obesity may play a direct role in the elevated hs CRP levels in women, but not men living in Singapore. This is probably due to different body composition or different effects of sex hormones on adipose tissue between men and women.

Android fat as a determinant of metabolic syndrome: Sex differences.

OBJECTIVES: Regional fat accumulation may play an important role in the pathogenesis of metabolic syndrome (MetS) and cardiovascular diseases, yet the results are controversial. The aim of this study was to determine the relationship between regional fat accumulation and MetS as well as the underlying mechanism in Chinese adults. METHODS: We conducted a cross-sectional study of 428 Chinese adults (166 men and 262 women). Android and gynoid fat percentage (AFP and GFP) were measured by dual energy x-ray absorptiometry. Fasting lipid parameters were analyzed by chemistry analyzer COBAS. RESULTS: Forty-six (28%) men and 34 (13%) women had MetS according to the modified National Cholesterol Education Panel Adult Treatment Panel III definition for South Asia. AFP was strongly correlated with more metabolic risk factors than GFP in men. In women, AFP and GFP showed significant opposite effects on triacylglycerol, high-density lipoprotein cholesterol, and waist circumference. On multivariate regression, AFP was an independent determinant of MetS in men after adjustment for confounding factors. For women, both AFP and the homeostatic model assessment for insulin resistance were predictors for MetS. CONCLUSIONS: Increased android fat may play a direct role in the development of MetS in Chinese adults. However, the associations between android fat, insulin resistance, and MetS are sex-dependent. This is probably due to different effects of sex hormones on adipose tissue or by genetic factors between sexes. Knowing the sex differences in developing MetS may help design sex-specific preventive strategies that will benefit the overall population health.

Is waist circumference more strongly associated with metabolic risk factors than waist-to-height ratio in Asians?

OBJECTIVES: Differential distribution of fats can vary among ethnic groups and thus have varying effects on metabolic risk. Measuring metabolic risk of individuals using simple anthropometric measurements is essential to replace current invasive methods of obtaining blood samples. Waist-to-height ratio (WHtR) has been advocated as the best simple anthropometric measurement, but, because of the high visceral fat of Asians, there has been speculation as to the possibility of using only waist circumference (WC) to measure metabolic risk. The aim of this study was to compare the performance of WC and WHtR in terms of their association with measures of obesity and metabolic risk factors (e.g., homeostasis model assessment for insulin resistance, low-density lipoprotein, triacylglycerol, and ratio of triacylglycerol to high-density lipoprotein) and to obtain an optimal cutoff value for one anthropometric measurement. METHODS: The study was performed on healthy Asian Chinese (N = 527) men (n = 209) and women (n = 318) who participated in a cross-sectional study conducted at the Clinical Nutrition Research Centre located in Singapore. Association of WC and WHtR with metabolic risk factors was obtained using Spearman's rank correlation coefficient. Optimal cutoff value was obtained using receiver operating characteristic curve. RESULTS: WC and WHtR performed equally well in both sexes in terms of their strength of association between metabolic risk factors. Receiver operating characteristic curve analysis showed that 73.5 cm (in women) and 82.5 cm (in men) were the optimal WC cutoff values to identify insulin resistance. CONCLUSION: It is suggested that WC is a simpler anthropometric measurement that has strong association with an individual's metabolic risk level.

Ultrasound measurement of intraabdominal fat thickness as a predictor of insulin resistance and low HDL cholesterol in Asians.

OBJECTIVES: Insulin resistance (IR) is important in the pathogenesis of diabetes, the prevalence of which has become a major public health threat in Asia. The aim of this study was to use ultrasound measurements of abdominal fat thickness to predict IR and low high-density lipoprotein cholesterol (HDL-C) levels among Singaporean adults. METHODS: A total of 399 healthy Singaporeans (mean age 36.7 ± 14.3 y; 43.4% men) took part in this study. Preperitoneal fat thickness (PFT) and subcutaneous fat thickness (SFT) were determined by ultrasound. RESULT: We found that both PFT and SFT had significant positive correlations (P < 0.05) with fasting insulin concentration, homeostasis model assessment of insulin resistance, triacylglycerol (TG), and blood pressure, and negatively correlated to serum HDL-C in all participants. Separating men and women, PFT was an independent determinant of IR and low HDL-C only in men. On receiver-operating characteristic curve analysis, PFT ≥1.2 cm was the optimal cutoff value to identify IR and low HDL-C in men. On the other hand, SFT was the determinant of IR, elevated TG, and low HDL-C only in women. An SFT of 1.1 cm was the optimal cutoff value to define IR, elevated TG, and low HDL-C in women. CONCLUSIONS: Results of this study suggested that ultrasound measurements of PFT and SFT could provide simple and useful indices of IR and lipid disorders for healthy Singaporean men and women. They might have the diagnostic values for predicting cardiovascular risks in this population.

New Equations to Predict Body Fat in Asian-Chinese Adults Using Age, Height, Skinfold Thickness, and Waist Circumference.

BACKGROUND: Adiposity is an independent predictor of metabolic disease. However, highly accurate body fat assessment is not routinely done due to limited access to expensive and labor-intensive methods. OBJECTIVE: The aim of the study was to develop body fat prediction equations for Asian-Chinese adults using easily attainable anthropometric measurements. DESIGN: Prediction equations of body fat were developed using anthropometric and skinfold thickness measurements obtained from a cross-sectional study. These new equations were then validated using baseline data from an independent randomized controlled study. PARTICIPANTS/SETTING: Healthy participants with no major diseases and not taking long-term medications were recruited in an ongoing cross-sectional study that began in June 2014 (n=439, 170 males, 269 females), as well as a randomized controlled trial (n=108, 58 males, 50 females) conducted from January 2013 to October 2014. Both the studies were conducted at Clinical Nutrition Research Center located in Singapore. MAIN OUTCOME MEASURES: Data used to develop and validate equations were from two original studies that assessed body fat by dual-energy x-ray absorptiometry, age, waist circumference, height, and biceps and triceps skinfolds. STATISTICAL ANALYSIS PERFORMED: Sex-specific percent body fat prediction equations were developed using stepwise regression with Akaike Information Criterion on the cross-sectional data. The equations were then validated using data from the randomized controlled study and also compared against Asian-specific Davidson equations. RESULTS: The best body fat prediction model (R2=0.722, standard error of estimation=2.97 for females; R2=0.815, standard error of estimation=2.49 for males) for both sexes included biceps and triceps skinfolds, waist circumference, age, and height. The new equations developed resulted in modest discrepancies in body fat of 1.8%±2.7% in males (P<0.001) and 0.7%±3.1% in females (P=0.125; not significant) compared with the Asian-specific Davidson equations (-7.4%±3.2% [P<0.001] and -7.4%±2.7% [P<0.001], respectively). CONCLUSIONS: Sex-specific equations to predict the percent body fat of Asian-Chinese adults with a higher degree of accuracy were developed. Ease of use in both field and clinical settings will be a major advantage.

Body Fat Measurements in Singaporean Adults Using Four Methods.

Few studies have been conducted to measure body composition in Asian populations. In this study, we determined the percent body fat (PBF) by using dual-energy X-ray absorptiometry (DEXA), air-displacement plethysmography (ADP or BOD POD), bioelectrical impedance analysis (BIA) and skinfold (SKF) in 445 healthy Singaporean adults. We observed that the BOD POD, BIA and SKF estimates of PBF were highly correlated with that from DEXA (as a reference method) among Singaporean adults. However, they all underestimated PBF (differences of 3.9% for BOD POD, 5.6% for BIA and 12.5% for SKF). Our results filled a gap in the literature by testing the relationships between DEXA and BOD POD, BIA and SKF in a large sample with a wide range of body mass index (BMI) from 16.1 to 37.5 kg/m² and age from 21 to 69.2 years. The differences of PBF measured by different methods were dependent on age, gender and ethnicity. No significant difference was observed between DEXA and BOD POD in men aged > 40 or in BMI tertile 3. However, the mean difference between DEXA and BOD POD was significant in women. Different measuring methods of estimating PBF therefore must be cautiously interpreted.

Does basal metabolic rate drive eating rate?

There have been recent advances in our understanding of the drivers of energy intake (EI). However, the biological drivers of differences in eating rate (ER) remain less clear. Studies have reported that the fat-free mass (FFM) and basal metabolic rate (BMR) are both major components that contribute to daily energy expenditure (EE) and drive EI. More recently, a number of observations report that higher ER can lead to greater EI. The current study proposed that adults with a higher BMR and higher energy requirements would also exhibit higher ERs. Data on BMR, FFM, and ER were collected from 272 Chinese adults (91 males and 181 females) in a cross-sectional study. Analysis showed significant positive associations between BMR and ER (rs = 0.405, p < 0.001), and between FFM and ER (rs = 0.459, p < 0.001). BMR explained about 15% of the variation in ER which was taken to be metabolically significant. This association provides metabolic explanation that the differences in an individual's BMR (hence energy requirements) may be correlated with ERs. This merits further research.

Spices in the management of diabetes mellitus.

Diabetes mellitus (DM) remains a major health care problem worldwide both in developing and developed countries. Many factors, including age, obesity, sex, and diet, are involved in the etiology of DM. Nowadays, drug and dietetic therapies are the two major approaches used for prevention and control of DM. Compared to drug therapy, a resurgence of interest in using diet to manage and treat DM has emerged in recent years. Conventional dietary methods to treat DM include the use of culinary herbs and/or spices. Spices have long been known for their antioxidant, anti-inflammatory, and anti-diabetic properties. This review explores the anti-diabetic properties of commonly used spices, such as cinnamon, ginger, turmeric, and cumin, and the use of these spices for prevention and management of diabetes and associated complications.