The effects of inulin-type fructans on cardiovascular disease risk factors: systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Inulin-type fructans (ITF) are the leading prebiotics in the market. Available evidence provides conflicting results regarding the beneficial effects of ITF on cardiovascular disease risk factors. OBJECTIVES: This study aimed to evaluate the effects of ITF supplementation on cardiovascular disease risk factors in adults. METHODS: We searched MEDLINE, EMBASE, Emcare, AMED, CINAHL, and the Cochrane Library databases from inception through May 15, 2022. Eligible randomized controlled trials (RCTs) administered ITF or placebo (for example, control, foods, diets) to adults for ≥2 weeks and reported one or more of the following: low, very-low, or high-density lipoprotein cholesterol (LDL-C, VLDL-C, HDL-C); total cholesterol; apolipoprotein A1 or B; triglycerides; fasting blood glucose; body mass index; body weight; waist circumference; waist-to-hip ratio; systolic or diastolic blood pressure; or hemoglobin A1c. Two reviewers independently and in duplicate screened studies, extracted data, and assessed risk of bias. We pooled data using random-effects model, and assessed the certainty of evidence (CoE) using the Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS: We identified 1767 studies and included 55 RCTs with 2518 participants in meta-analyses. The pooled estimate showed that ITF supplementation reduced LDL-C [mean difference (MD) -0.14 mmol/L, 95% confidence interval (95% CI: -0.24, -0.05), 38 RCTs, 1879 participants, very low CoE], triglycerides (MD -0.06 mmol/L, 95% CI: -0.12, -0.01, 40 RCTs, 1732 participants, low CoE), and body weight (MD -0.97 kg, 95% CI: -1.28, -0.66, 36 RCTs, 1672 participants, low CoE) but little to no significant effect on other cardiovascular disease risk factors. The effects were larger when study duration was ≥6 weeks and in pre-obese and obese participants. CONCLUSION: ITF may reduce low-density lipoprotein, triglycerides, and body weight. However, due to low to very low CoE, further well-designed and executed trials are needed to confirm these effects. PROSPERO REGISTRATION NUMBER: CRD42019136745.

Facteurs influençant l'apport alimentaire en rations des soldats canadiens dans l'Arctique : un sondage national.

Purpose: To document Canadian Armed Forces (CAF) soldiers' perceptions of factors influencing their dietary intake of combat rations during Arctic field training.Methods: A bilingual digital questionnaire was sent nationally to soldiers who trained in the Arctic between 2015 and 2018. It consisted of 6 open-ended and 33 closed-ended questions on factors influencing ration intake and acceptability.Results: Of the 54 completed questionnaires (response rate: 31%), 6 were incomplete and were excluded. The final sample consisted of 48 military personnel from nine provinces with an average of 12.1 ± 6.8 years of CAF experience. Factors with the greatest negative impact on dietary intake were food temperature, eating on the move, exercise and activity schedules, and equipment needed for preparation and eating. Participants reported consuming between 61% and 71% of their rations. They noted that a considerable amount of time was required to prepare the rations since they were frozen. Sixty-five percent of soldiers reported weight loss while training in the Arctic.Conclusions: Multiple factors influenced soldiers' dietary intake and practices. These results will guide future research and assist in decision-making regarding possible changes to Arctic rations.

Objectif. Documenter la perception des soldats des Forces armées canadiennes (FAC) quant aux facteurs influençant leur apport alimentaire en rations de combat durant leur travail en Arctique.Méthodes. Un questionnaire bilingue électronique a été envoyé nationalement à des soldats s'étant entraînés dans l'Arctique entre 2015 et 2018. Il comportait 6 questions ouvertes et 33 fermées sur les facteurs influençant l'apport alimentaire et l'acceptabilité des rations.Résultats. Parmi les 54 questionnaires remplis (taux de réponse : 31 %), 6 étaient incomplets et ont été exclus. L'échantillon final était composé de 48 militaires de neuf provinces ayant en moyenne 12,1 ± 6,8 années d'expérience dans les FAC. Les facteurs ayant le plus d'effets négatifs sur l'apport alimentaire étaient la température des aliments, le fait de manger en se déplaçant, l'horaire des exercices et activités, ainsi que l'équipement nécessaire à la préparation et à la consommation. Les participants ont déclaré avoir consommé entre 61 et 71 % des rations. Ils ont noté qu'un temps considérable était nécessaire pour préparer les rations puisqu'elles étaient congelées. Soixante-cinq pour cent des soldats ont rapporté une perte de poids durant leur travail dans l'Arctique.Conclusions. Une multitude de facteurs a influencé l'apport et les pratiques alimentaires des soldats. Ces résultats guideront les recherches futures et aideront à la prise de décisions concernant de possibles changements aux rations en Arctique.

Soldiers' Perception of Combat Ration Use During Arctic Training: A Qualitative Study.

INTRODUCTION: Soldiers work in various extreme environments, including the High Arctic, where energy requirements are increased compared with temperate climates. Soldiers often do not reach their energy needs with combat rations and face additional challenges to feeding in the Artic, which can hinder the performance. The purpose of this study is to document soldiers' perception about individual, dietary, and environmental factors influencing intake of combat rations during Arctic field training. MATERIALS AND METHODS: This qualitative phenomenological study included in-depth semi-structured individual interviews with 16 soldiers of the Canadian Armed Forces participating in the Arctic Operations Advisor training in Yellowknife (Northwest Territories) and Resolute Bay (Nunavut) from January to March 2019. Interviews were audio-recorded, transcribed verbatim, and then coded using a directed content analysis approach. Data were analyzed with NVivo qualitative data analysis software. RESULTS: Five themes related to the individual (personal preferences; mood and morale), the diet (water availability; food variety), or the environment (meal preparation time) were identified. A sixth theme found was related to the diet and the environment (food/water temperature). Soldiers explained food and water were frozen, thus limiting water availability and greatly increasing meal preparation time. Food variety was deemed adequate by some, but others preferred more options. Individual food preferences and soldier mood and team morale could be barriers or facilitators to intake. Overall, the complexity of combat ration intake in the Arctic stemmed from the interaction of factors. CONCLUSIONS: Various factors related to the individual, diet, and environment were found to influence intake of combat rations by participating soldiers during Arctic training. Reducing barriers to combat ration consumption by enhancing operational suitability of rations for the Arctic environment could promote dietary intake. Bearing in mind many interrelated factors influenced intake of soldiers, the military would benefit from further assessing which challenges related to intake in the field could be addressed.