Exposure to Instagram junk food content negatively impacts mood and cravings in young adults: A randomized controlled trial.

Exposure to different types of images on social media is known to affect physical and mental wellbeing including changes in perception of body image (BI) and dietary behavior. The present study aimed to assess the effects of junk food-related Instagram content exposure on body image, overall mood, and cravings in young adults. A randomized crossover experimental design was used. After filling out a baseline survey, participants (n = 63, aged 18-24) browsed either a control Instagram account feed or an account rich in junk food images during 15 min. They then filled a short survey evaluating their state BI, mood, and cravings (T1). After a 1-week washout period (T2), participants browsed the other account type followed by the same short survey as in T1. Results showed that exposure to junk food content was associated with increased feelings of hunger, stress, sadness, and exhaustion, in addition to higher salty, savory, and fatty food cravings. Moreover, participants showed higher desire for junk food and lower desire for healthy food items from a virtual food tray after junk food content exposure. There was no impact of content type on state BI dissatisfaction. In conclusion, exposure to junk-food related content on social media negatively affects mood and cravings, subsequently influencing food choices. The present findings shed light on the need for interventions aimed at providing cognitive and emotional competencies for enhancing media literacy and promoting mindful social media use.

Determinants of body image disturbance and disordered eating behaviors among self-identified LGBTQ individuals.

It has been previously established that sexual minorities are more likely to suffer from mental health illnesses due to experiencing unique stressors such as fear, anxiety, stigma, harassment, and prejudice. Results revealed two noteworthy mental health disorders reported by lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, disordered eating behaviors and disturbed body image. Yet, a-priori studies revealed inconsistent results with regards to body image concerns and eating disorder symptoms and attitudes among sexual minorities. Therefore, this cross-sectional study aimed at investigating the occurrence of disordered eating behaviors (DEB) and body image disturbance (BID) among sexual minorities in Lebanon. Additionally, the correlation between several determinants of DEB and BID including fear of negative evaluation, generalized anxiety, social support, and harassment levels have been examined. Generally, the present study revealed that LGBTQ population scored higher than cisgender and heterosexual individuals for the mean and global scores of the EDE-Q6.0 and BAS-2. Only generalized anxiety and fear of negative evaluation scales were significantly associated with DEB and BID among different sexual orientation and gender identity individuals. Therefore, it is very important that health professionals working with such vulnerable populations meticulously assess for disordered eating behaviors and body image disturbance for better communication and management.

Effectiveness of a text-messaging intervention on intuitive eating: a randomised controlled trial.

Intuitive eating (IE) is a concept based on mind-body integration of instinct, emotion and rational thought, to improve eating behaviours, physical and mental health. Several attempts were developed to teach IE principles including text-messaging interventions given that they are easy to implement and low cost. OBJECTIVE: The present study aimed to assess the effectiveness of a 5-week text message-based IE intervention on IE, while correcting for perceived stress (PS) and self-compassion (SC). DESIGN: A randomised controlled trial. SETTING: Online, in Lebanon. PARTICIPANTS: Adults (n 195) were randomised into one of three groups: the active IE group receiving IE-related messages with a practice exercise, the passive IE group receiving only IE-related messages and the control group receiving general health-related tips. Ten messages were delivered over 5 weeks. Two follow-ups were made: directly post-intervention and 7 weeks later. Baseline data and follow-ups included demographics, nutrition-related variables and measures of IE, SC and PS. RESULTS: Results indicated improvements in IE scores in the two intervention groups (P = 0·05), with the passive IE group showing the most improvement. Also, a significant improvement in SC (Λ = 0·88, F (2, 63) = 4·40, P = 0·01) and reduction in PS (Λ = 0·86, F (2, 63) = 5·21, P = 0·008) were observed in the active IE group. CONCLUSION: Text-messaging interventions might be efficient in enhancing IE. Results shed light on the need for further large-scale interventions that use visual aids and provide practical guidance to teach IE, while further characterising the relation between IE, SC and stress.

Is diabetic neuropathy associated with vitamin D status? A meta-analysis.

Several studies have been conducted to investigate the relation between 25-hydroxyvitamin D [25(OH)D] level and diabetic neuropathy (DN). However, there is still no clear conclusion due to differences in study design and cut-off values used in the published work, in addition to the absence of a comprehensive meta-analysis (MA) on the topic. The present systematic review and MA therefore aims at clarifying the association between vitamin D level and peripheral DN in patients with type 2 diabetes mellitus. Primary research studies that explored the association between 25(OH)D level and diabetic peripheral neuropathy in type 2 diabetes were located from Medline, EMBASE, Web of Science, Cochrane Library, CINHAL and Google Scholar. Twenty-six studies met the inclusion criteria with 6277 participants where 2218 were diabetic with DN, 2959 were diabetic without DN and 406 were healthy. Diabetic patients with DN showed significantly lower serum 25(OH)D compared with patients without DN (standardised mean difference (SMD) of -0·92 (95 % CI -1·18, -0·65, I2 = 93·3 %, P < 0·0001). The pooled OR value of vitamin D deficiency was higher in patients with DN, 1·84 (95 % CI 1·46, 2·33, P < 0·0001) and 2·87 (95 % CI 1·10, 7·52, P = 0·03) when using fixed-effects and random-effects models, respectively. Vitamin D deficiency has been found to be highly prevalent among diabetic patients with neuropathy. Since 25(OH)D has been implicated in glucose haemostasis and showed benefit in reducing neuropathy symptoms, its supplementation is warranted for this population of patients.

Assessment of the World Food Programme summer camps in Lebanon: a model of effective interventions for vulnerable adolescents.

The World Food Programme (WFP) offers yearly health and nutrition summer camps hosting vulnerable Syrian and Lebanese children and aiming at improving physical, mental and social well-being while contributing to better social cohesion. The present study aimed to assess the 2019 WFP summer camps' effectiveness in reaching the intended outcomes and to provide recommendations for improvement. A multi-method approach using (1) quantitative student pre-/post-surveys (n 443), (2) focus group discussions and (3) key informant interviews and surveys (n 42) was adopted. Mean test results showed improvements in nutrition (4·79 (sd 1·9) v. 5·34 (sd 2·7); t(269) = 4·51, P = 0·000) and life skills knowledge (4·97 (sd 1·9) v. 5·55 (sd 2); t(294) = 4·52, P = 0·000) but no improvement in health knowledge and social cohesion scores. Qualitative data revealed positive changes in social cohesion and an increase in health knowledge. In addition, there was a positive attitude towards the summer camps from students, instructors and administrators specifically regarding the integrated content, snacks and atmosphere of fun and learning. The main weaknesses identified were the short time to prepare for the camps, shortage in instructor training and short camp duration. There were also points of debate regarding sexual and reproductive health-related topics and how they should be delivered. All in all, the camps were shown to be a commendable initiative for incorporating an integrated and holistic approach in the support of education and development among vulnerable children and adolescents.

Ghrelin-induced multi-organ damage in mice fed obesogenic diet.

OBJECTIVE AND DESIGN: Ghrelin has a key role in modulating energy metabolism and weight gain. The present study aimed at studying the potential role of ghrelin in the development and/or exacerbation of organ damage in a mouse model of diet-induced obesity. OBJECTIVE AND DESIGN: Adult mice were fed one of two diets for 20 weeks: standard high carbohydrate (HC) or high-fat high-sugar (HFHS). Starting week 17, the animals were given regular intraperitoneal ghrelin (160 µg/kg) or saline injections Abdominal fat, serum creatinine, and glucose levels, as well as kidney, liver and heart weight and pathology were assessed. RESULTS: Ghrelin-injected mice showed significant organ damage, which was more exacerbated in HFHS-fed animals. While the HFHS diet was associated with significant liver damage, ghrelin administration did not reverse it. Interestingly, ghrelin administration induced moderate kidney damage and significantly affected the heart by increasing perivascular and myocardium fibrosis, steatosis as well as inflammation. Moreover, serum creatinine levels were higher in the animal group injected with ghrelin. CONCLUSION: Ghrelin administration was associated with increased functional and structural organ damage, regardless of diet. The present study provides novel evidence of multi-organ physiologic alterations secondary to ghrelin administration.

Branched-chain amino acids mediate resilience to chronic social defeat stress by activating BDNF/TRKB signaling.

How individuals respond to chronic stress varies. Susceptible individuals ultimately develop depression; whereas resilient individuals live normally. In this study, our objective was to examine the effect of branched-chain amino acids (BCAA), commonly used by athletes, on susceptibility to stress. Male C57BL/6 mice were subjected to daily defeat sessions by a CD1 aggressor, for 10 days. On day11, the behavior of mice was assessed using the social interaction test, elevated plus maze and open field. Mice received the BCAA leucine, isoleucine or valine before each defeat session. Furthermore, we examined whether BCAA regulate brain derived neurotrophic factor (BDNF) signaling by using a brain-permeable tropomyosin receptor kinase B (TRKB) inhibitor, ANA-12. We also tested the effect of voluntary exercise and high protein diets on susceptibility to stress. Mice exposed to chronic stress displayed increased susceptibility and social avoidance. BCAA promoted resilience to chronic stress, rescued social avoidance behaviors and increased hippocampal BDNF levels and TRKB activation. Inhibition of TRKB signaling abolished the ability of BCAA to promote resilience to stress and to rescue social avoidance. Interestingly, we found that BCAA activate the exercise-regulated PGC1a/FNDC5 pathway known to induce hippocampal BDNF signaling. Although both voluntary exercise and BCAA promoted resilience to stress, combining them did not yield synergistic effects confirming that they affect similar pathways. We also discovered that high protein diets mimic the effect of BCAA by rescuing social deficits induced by chronic stress and increase Bdnf expression in the hippocampus. Our data indicate that BCAA, exercise and high protein diets rescue susceptibility to stress by activating the hippocampal BDNF/TRKB signaling.

Personality, emotion-related variables, and media pressure predict eating disorders via disordered eating in Lebanese university students.

PURPOSE: Disordered eating behaviors are on the rise among youth. The present study investigates psychosocial and weight-related variables as predictors of eating disorders (ED) through disordered eating (DE) dimensions (namely restrained, external, and emotional eating) in Lebanese university students. METHODS: The sample consisted of 244 undergraduates (143 female) aged from 18 to 31 years (M = 20.06; SD = 1.67). Using path analysis, two statistical models were built separately with restrained and emotional eating as dependent variables, and all possible direct and indirect pathways were tested for mediating effects. The variables tested for were media influence, perfectionism, trait emotional intelligence, and the Big Five dimensions. RESULTS: In the first model, media pressure, self-control, and extraversion predicted eating disorders via emotional eating. In the second model, media pressure and perfectionism predicted eating disorders via restrained eating. DISCUSSION: Findings from this study provide an understanding of the dynamics between DE, ED, and key personality, emotion-related, and social factors in youth. Lastly, implications and recommendations for future studies are advanced.

Implementing an interprofessional education programme in Lebanon: overcoming challenges.

BACKGROUND: The Lebanese American University has a well-functioning inter-professional education (IPE) programme; this is a fundamental pedagogical approach in healthcare education in which students from different professions learn together, ultimately leading to improving the skills of the health care workforce and thus improving patient outcomes. The programme includes nursing, nutrition, medicine, pharmacy and social work students, and has now been running for 6 years. AIMS: This paper aims at describing the implementation of an IPE programme in Lebanon by focusing on how to overcome the main challenges. METHODS: We describe our experience using the categories of challenges developed by Sunguya et al. (2014), where they analysed published reports of IPE programmes in developed countries. We identified three additional challenges that might be relevant throughout the Middle East/North Africa (MENA) region or in countries with similar socioeconomic characteristics. RESULTS: The challenges encountered in designing and implementing the IPE programme were similar to other programmes: curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargon and accreditation as well as assessment of learning, security and logistics. CONCLUSIONS: This paper provides data and successful strategies that can be used by planned or implemented programmes in similar socioeconomic contexts in the MENA region.

Media, Technology Use, and Attitudes: Associations With Physical and Mental Well-Being in Youth With Implications for Evidence-Based Practice.

BACKGROUND: Previous research has shown that the use of technology and media, in their different available forms, may have detrimental effects on the physical and mental well-being of adolescents and young adults. AIMS: The present study aimed to investigate the use of different types of technology and media, attitudes toward them, and how they relate to physical and mental well-being in Lebanese university students. METHODS: A descriptive, correlational, cross-sectional design was used. A sample of 244 undergraduates completed a self-report measuring media and technology use and attitudes, eating-related variables (e.g., healthy eating, body image dissatisfaction [BID], and eating disorders [EDs] risk), trait emotional intelligence (TEI), and psychopathology indicators (stress, anxiety, and depression). RESULTS: The use of mobile phone multimedia (music, pictures, and videos) correlated with unhealthy eating and stress. Social media use was associated with BID, EDs risk, and the self-control construct of TEI. Anxiety of separation from technological devices and dependence on them was associated with increased BID, EDs risk, depression, and anxiety. LINKING EVIDENCE TO ACTION: Practical implications are discussed in terms of setting limits and boundaries on technology use during childhood and adolescence, and encouraging healthy eating and physical activity at home and on college campuses. Moreover, social media could be used as a platform for intervention and prevention programs to decrease BID, EDs, depression, and anxiety.

Investigating Vulnerability for Developing Eating Disorders in a Multi-confessional Population.

The present study aimed to examine the vulnerability to eating disorders (ED) among 949 Lebanese female young adults as well as its association with stress, anxiety, depression, body image dissatisfaction (BID), dysfunctional eating, body mass index, religious affiliation (Christian, Muslim, Druze or Other), religiosity and activity level. Results showed that anxiety had the greatest effect on increasing the predisposition to ED, followed by stress level, BID, depression and restrained eating. Affiliating as Christian was found to significantly decrease the vulnerability to developing an ED. Furthermore, the interaction of anxiety with intrinsic religiosity was found to have a protective role on reducing ED. The current study emphasized a buffering role of intrinsic religiosity against anxiety and ED vulnerability.

Eating Disorders in Lebanon: Directions for Public Health Action.

Research in the field of eating disorders (ED) is limited in the Middle East. The aim of the present study was to profile Lebanese ED outpatients. A mixed-method design was used. Clinicians across Lebanon filled individual questionnaires about their 2013 ED outpatients (n = 104) and participated in focus groups. Results showed that bulimia nervosa was the most prevalent ED (46.1 %) followed by anorexia nervosa (39.4 %) and binge eating (14.4 %). The emerging socio-demographic profile of the Lebanese ED patient was that of a single female young adult of middle to high socio-economic status with severe ED symptoms (amenorrhea, multiple purging behaviors) and depression. Also, there was a general delay in seeking help which made patient recovery more difficult. The present study emphasizes the critical need for a public health approach to ED awareness and could help in developing preventive and remedial educational programs targeting youth in Lebanon and the Middle East.

Student perceptions towards interprofessional education: Findings from a longitudinal study based in a Middle Eastern university.

The Lebanese American University Interprofessional Education (LAU IPE) Steps Framework consists of a five-step workshop-based series that is offered throughout the curriculum of health and social care students at an American university in Lebanon. The aim of the present study was to report students' perceptions of their readiness for interprofessional learning before and after completing the IPE steps, their evaluations of interprofessional learning outcomes, as well as their satisfaction with the learning experience as a whole. A longitudinal survey design was used: questionnaires were completed by students before IPE exposure and after each step. The results showed that before IPE exposure, students' perceptions of their readiness for interprofessional learning were generally favourable, with differences across genders (stronger professional identity in females compared to males) and across professions (higher teamwork and collaboration in pharmacy and nutrition students compared to other professions and lower patient centredness in nursing students compared to others). After participation in the IPE steps, students showed enhanced readiness for interprofessional learning and differences between genders and professions decreased. Participants were satisfied with the learning experience and assessment scores showed that all IPE learning outcomes were met. The LAU IPE Steps Framework may be of value to other interprofessional education course developers.

Effectiveness of a Technology-Based Intervention to Teach Evidence-Based Practice: The EBR Tool.

BACKGROUND: As the world becomes increasingly digital, advances in technology have changed how students access evidence-based information. Research suggests that students overestimate their ability to locate quality online research and lack the skills needed to evaluate the scientific literature. Clinical nurses report relying on personal experience to answer clinical questions rather than searching evidence-based sources. To address the problem, a web-based, evidence-based research (EBR) tool that is usable from a computer, smartphone, or iPad was developed and tested. The purpose of the EBR tool is to guide students through the basic steps needed to locate and critically appraise the online scientific literature while linking users to quality electronic resources to support evidence-based practice (EBP). METHODS: Testing of the tool took place in a mixed-method, quasi-experimental, and two-population randomized controlled trial (RCT) design in a U.S. and Middle East university. RESULTS: A statistically significant improvement in overall research skills was supported in the quasi-experimental nursing student group and RCT nutrition student group using the EBR tool. A statistically significant proportional difference was supported in the RCT nutrition and PharmD intervention groups in participants' ability to distinguish the credibility of online source materials compared with controls. The majority of participants could correctly apply PICOTS to a case study when using the tool. CONCLUSIONS: The data from this preliminary study suggests that the EBR tool enhanced student overall research skills and selected EBP skills while generating data for assessment of learning outcomes. LINKING EVIDENCE TO ACTION: The EBR tool places evidence-based resources at the fingertips of users by addressing some of the most commonly cited barriers to research utilization while exposing users to information and online literacy standards of practice, meeting a growing need within nursing curricula.

Anxiety as a Moderator of the Relationship Between Body Image and Restrained Eating.

PURPOSE: To examine three indicators of psychopathology (stress, anxiety, and depression) as potential moderators of the relationship between body image dissatisfaction (BID) and restrained, emotional, and external eating, while controlling for family-related variables (i.e., household income, living situation, and psychopathology in the family) and individual variables (i.e., body mass index, physical activity, and major life events). DESIGN AND METHODS: A descriptive, correlational cross-sectional design was used. A sample of 894 female undergraduates aged between 18 and 25 completed a self-reported questionnaire. FINDINGS: Moderation analyses indicated that anxiety significantly moderated the relationship between BID and restrained eating, whereas depression and stress did not. PRACTICE IMPLICATIONS: Findings may be used in the development and implementation of education and prevention programs for disordered eating in college campuses. The usefulness of these findings for nursing practice is discussed.

Herbal Products and Dietary Supplements: A Cross-Sectional Survey of Use, Attitudes, and Knowledge Among the Lebanese Population.

There has been a marked increase in use of herbal products and dietary supplements (HP/DS) in many developed and developing countries. However, data about consumption patterns and awareness about these products in the Lebanese population is scarce. The present study aimed to examine the determinants of HP/DS use in Lebanese adults, identify potential interactions and safety concerns and assess the knowledge and attitudes of consumers towards the efficacy and safety of these products. A face-to-face, 28-item survey was administered to Lebanese adults (n = 726) in community pharmacies across the country. Thirty-five percent of participants reported to be currently consuming at least one HP/DS including 23 % who were consuming vitamins and/or mineral supplements and 18 % consuming herbal products. Significant safety concerns were identified among consumers in the form of disease-supplement, drug-supplement as well as supplement-supplement interactions. Logistic multivariate regression analysis indicated that use of supplements was positively associated with the female gender and increasing age. The majority of respondents falsely believed that HP/DS pose no risk to the general population and that they must be safe to be sold in Lebanon. Moreover, most participants were consuming these products based on recommendations from friends or relatives rather than from healthcare professionals. Substantial misconceptions about HP/DS exist among Lebanese adults, indicating a need for consumers' education from professional and reliable sources on the efficacy and safety of such products.

Effects of Recording Food Intake Using Cell Phone Camera Pictures on Energy Intake and Food Choice.

BACKGROUND: The well-documented increases in obesity and unhealthy dietary practices substantiate the need for evidence-based tools that can help people improve their dietary habits. The current spread of mobile phone-embedded cameras offers new opportunities for recording food intake. Moreover, the act of taking pictures of food consumed may enhance visual consciousness of food choice and quantity. The present study aimed to assess the effect of using cell phone pictures to record food intake on energy intake and food choice in college students. The effectiveness and acceptability of cell phone picture-based diet recording also was assessed. METHODS: A repeated measures crossover design was used. One group of participants entered their food intake online during 3 days based on their memory, although a second group recorded their food intake using cell phone pictures as their reference. Participants then crossed over to complete 3 more days of diet recording using the alternate method. Focus groups were conducted to obtain feedback on the effectiveness and acceptability of cell phone picture-based diet recording. RESULTS: Intake of meat and vegetable servings were significantly higher in the memory period compared with the cell phone period, regardless of the order. Results from the focus group indicated a positive attitude toward the use of cell phone pictures in recording food intake and an increased awareness of food choice and portion size. LINKING EVIDENCE TO ACTION: Cell phone pictures may be an easy, relevant, and accessible method of diet self-monitoring when aiming at dietary changes. Future trials should combine this technique with healthy eating education.

Salvia libanotica improves glycemia and serum lipid profile in rats fed a high fat diet.

BACKGROUND: Salvia libanotica (S. Libanotica) is a commonly used herb in folk medicine in Lebanon and the Middle East. The present study aimed to assess the scientific basis for the therapeutic use of S. libanotica in glycemia and to evaluate its effects on lipemia and abdominal fat. METHODS: Animals were fed a high-fat diet and allocated into a control and three experimental groups (GI, GII and GIII) receiving incremental doses of the plant water extract in drinking water (50, 150 and 450 mg/Kg body weight respectively) for six weeks. RESULTS: The intake of S. libanotica extract was associated with a significant decrease in fasting serum glucose (102.9 ± 10.8 in GII and 87.5 ± 6.4 in GIII vs. 152.1 ± 7.9 mg/dl in controls) and a two fold increase in fasting serum insulin (GIII) and liver glycogen content (GII and GIII). Group III also had better glucose tolerance following intraperitoneal glucose challenges. Additionally, the plant extract intake produced a significant improvement in serum HDL (34.4 ± 2.4 in GIII vs. 27.2 ± 1.9 mg/dl in controls) and HDL/LDL cholesterol ratio (2.79 ± 0.32 in GII and 3.02 ± 0.31 in GIII vs. 1.74 ± 0.18 in controls), as well as a decrease in abdominal fat. CONCLUSION: The current study is the first to demonstrate that the chronic intake of S. libanotica infusion helps in the prevention of high fat-induced hyperglycemia and dyslipidemia. This supports the plant use as a remedy for the prevention of type 2 diabetes and cardiovascular diseases.

Cafeteria diet-fed mice is a pertinent model of obesity-induced organ damage: a potential role of inflammation.

OBJECTIVE: This study is aimed at evaluating the effects of a cafeteria diet (obesity) mouse model on early multi-organ functional, structural, endocrine and biochemical alterations. MATERIALS AND METHODS: Multi-organ damage is assessed using clinical, biochemical, pathological, and inflammatory parameters in 30 mice fed one of the three diets for 15 weeks: standard chow diet (SC), high fat (HF), or "Cafeteria diet" (CAF) (standard SC and a choice of highly palatable human cafeteria foods: chocolate, biscuits, and peanut butter). RESULTS: CAF diet was associated with an increase in body weight, energy intake, and serum cholesterol levels compared to the other diets, as well as higher insulin levels and lower glucose tolerance. Additionally, consumption of the CAF diet was associated with significantly higher weight gain, abdominal fat, and serum IL-6 levels, as well as more damage in the heart (coronary perivascular fibrosis and steatosis), kidney (chronic interstitial inflammation and glomerular sclerosis), and liver (liver weight, portal fibrosis, apoptosis, and steatosis) compared to the HF diet. CONCLUSION: Functional and structural damage in CAF were higher than HF of similar macronutrient composition. This study provides a novel dietary model in mice that mimics multi-organ physiologic alterations in humans secondary to obesity.

Tragopogon porrifolius improves serum lipid profile and increases short-term satiety in rats.

Tragopogon porrifolius (white salsify) is an edible plant commonly used in folk medicine in Lebanon and neighbouring countries. This study investigates the effect of the aqueous extract of the aerial part of T. porrifolius on lipemia and appetite regulation using a rat model. Food intake, abdominal fat percentage, blood lipid profile, liver weight and liver enzymes were assessed following 4 weeks of extract intake via drinking water (50, 100, or 250 mg/kg body weight) in standard high-carbohydrate and high-fat dietary conditions. In a separate study, the short term effect of a preload of T. porrifolius extract on food intake was evaluated. Results showed that consumption of the plant extract for a period of four weeks resulted in a marked improvement of the lipid profile (triglycerides, total cholesterol, LDL and HDL cholesterol). Body weight, food intake and intra-abdominal fat were also lower in animals given the plant extract (100 and 250 mg/kg). In addition, T. porrifolius extract preload produced a dose dependent decrease in food intake observed over 24h. The intake of T. porrifolius aqueous extract therefore improved lipemia and increased satiety in rats with no visible adverse effects.