The Effects of a Mindfulness-Based Family Psychoeducation Intervention for the Caregivers of Young Adults with First-Episode Psychosis: A Randomized Controlled Trial.

OBJECTIVE: In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program. METHOD: We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes. RESULTS: Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers' outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F = 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement. CONCLUSIONS: A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size.

Effect of lifelong sucrose consumption at human-relevant levels on food intake and body composition of C57BL/6N mice.

Introduction: Controversies surround the issue if chronic consumption of a high-sugar diet is detrimental to health or not. This study investigates whether lifelong consumption of a higher sucrose diet will induce overeating, and obesity, and cause metabolic dysfunctions such as hyperglycemia and dyslipidaemia in C57BL/6N mice, compared to a lower sucrose diet. Methods: Male C57BL/6N mice at 3 weeks of age were randomized into consuming a diet with 25 or 10% kcal from sucrose for the rest of their lives. Body weight, food and water intake, fasting blood glucose, insulin, and lipid levels were measured at regular intervals. At the end of the study, organs and tissues were collected and gene expression was measured. Results: There was no discernible difference in the impact on food intake, body composition, glucose and lipid homeostasis, liver triglyceride content, life expectancy, as well as gene expression related to intermediary metabolism between mice fed a diet with 10 vs. 25% kcal as sucrose over their lifespan. We also showed that switching from a 25% kcal diet to a 10% kcal diet at different life stages, or vice versa, did not appear to affect these outcomes of interest. Discussion: The results from our study suggest that lifelong consumption of a higher sugar diet generally did not induce overeating and obesity, disrupt carbohydrate metabolism and lipid homeostasis, and reduce life expectancy compared with a lower sugar diet. Our unorthodox findings disagreed with the popular belief that higher sugar consumption is detrimental to health, which should be confirmed in future studies.

Effect of using commercial pre-packaged baby foods on the Fe intake of 7-8 months old infants.

OBJECTIVES: To examine the potential effect on Fe intake of 7-8 months old infants if pre-packaged baby foods (PBF) were used as the sole source of complementary foods. DESIGN: Based on the 7-d recommended feeding plan for 7-8 months old infants in Hong Kong (moderate Fe-fortified rice cereal with home-cooked meals), twenty-four modelling scenarios were created which comprised of two milk use modes (breastmilk v. infant formula), three modes of rice cereal use (no-rice cereal; non-Fe-fortified rice cereal and Fe-fortified rice cereal) and four baby foods usage modes (home-cooked meals; low-Fe PBF only; high-Fe PBF only and mixed PBF). The PBF were randomly selected in each of the models and substituted the original meals/snacks. The average daily Fe intakes of the modelled meal plans were compared with the Chinese estimated average requirement (EAR) and recommended nutrient intake (RNI) for Fe. SETTING: Modelling study. PARTICIPANTS: Not applicable. RESULTS: In general, the infant-formula-based complementary feeding pattern (CFP) had higher average daily Fe intake when compared with breastmilk-based CFP. The Fe intakes of all scenarios under the breastmilk-based CFP were below the RNI and EAR, except for the fortified rice cereal meal plans with high-Fe or mixed PBF. For infant-formula-based CFP, the Fe intakes were close to or above the RNI regardless of types of PBF or rice cereal used. CONCLUSIONS: The inclusion of fortified rice cereal was important in maintaining adequate Fe intake for infants, especially for breast-fed infants. The replacement of home-cooked meals by low-Fe PBF could potentially put infants at risk of Fe deficiency.

Iron content and fortification status of a sample of local and imported pre-packaged baby foods available in Hong Kong.

AIM: To examine the iron content and fortification status of pre-packaged baby foods in Hong Kong. METHODS: Data of 472 pre-packaged baby foods were collected from various distribution points in Hong Kong in July-August 2018. Item descriptors, iron content, ingredients list, country of origin, organic status and iron-related guidelines displayed on the package were recorded. Between group differences in the median (IQR) iron content were compared by the Mann-Whitney U test; and by Pearson's χ2 test for the proportion of pre-packaged baby foods that were iron-fortified or displaying iron-related guidelines, stratified by country of origin and organic status where appropriate. RESULTS: Only 79 out of 472 pre-packaged baby foods displayed iron content on their labels, and their median iron content was 6.80 (1.3-20.0) mg/100 g. Of these, cereals [14.0 (12.0-32.0)] and snacks and finger foods [12.6 (1.4-21.3)] had significantly higher iron content than other pre-packaged baby foods. Less than 20% of pre-packaged baby foods in Hong Kong were iron-fortified. North American pre-packaged baby foods (49.2%) were more likely than those from other places of origin (all P < .001) to be iron-fortified, and marginally more non-organic pre-packaged baby foods were iron-fortified products than organic (23.6% vs 16.2%, P = .043). Only 17.2% of products included iron-related guidelines/cautions on their packaging. CONCLUSIONS: The majority of pre-packaged baby foods available in Hong Kong lacked iron fortification, and did not display iron-related guidelines/cautions or their iron content on the package. Given the inconsistent fortification practices by manufacturers, labelling of iron content should be mandatory to assist parents in identifying iron-rich pre-packaged baby foods.

The effect of a low glycaemic index diet on reducing day-long glycaemia in healthy young adults: A randomized crossover trial.

AIM: To compare the effect of a low glycaemic index (LGI) diet on reducing day-long glycaemia with a macronutrient-matched high glycaemic index (HGI) diet, using customized meal delivery to ensure compliance. MATERIALS AND METHODS: We conducted a single-blinded, randomized crossover trial in 14 healthy adults (57% female) with a mean ± SD age of 21.6 ± 1.7 years. A flash glucose monitoring sensor was installed on the subjects on day 1 to capture the interstitial glucose level every 15 minutes for 14 days. Subjects were randomized to receive an LGI (dietary GI = 40) or HGI (dietary GI = 60) diet (three meals and two snacks) from day 2 for 5 consecutive days, followed by a 2-day washout, then switched to the alternative diet for another 5 days. A paired t-test was used to test the differences in the incremental area under the curve (iAUC) of glucose, postprandial glucose (PPG) concentration and maximum postprandial glucose rise (MPGR) between the LGI and HGI periods. RESULTS: Subjects had lower iAUC for average day-long glycaemia during the LGI intervention period compared with the HGI period (mean ± SD, 865 ± 297 vs. 1024 ± 267 mmol x min/L; P = .047). PPG for breakfast and snack 2, and MPGR for breakfast, snack 2 and dinner, were lower in the LGI period. CONCLUSIONS: In young healthy adults, following an LGI diet resulted in lower average day-long glycaemia compared with a macronutrient-matched HGI diet. Our results support the use of LGI diets to reduce the risk of developing glucose intolerance.

Consuming decaffeinated coffee with milk and sugar added before a high-glycaemic index meal improves postprandial glycaemic and insulinaemic responses in healthy adults.

The present study aimed to compare the effects of drinking different types of coffee before a high-glycaemic index (GI) meal on postprandial glucose metabolism and to assess the effects of adding milk and sugar into coffee. In this randomised, crossover, acute feeding study, apparently healthy adults (n 21) consumed the test drink followed by a high-GI meal in each session. Different types of coffee (espresso, instant, boiled and decaffeinated, all with milk and sugar) and plain water were tested in separate sessions, while a subset of the participants (n 10) completed extra sessions using black coffees. Postprandial levels of glucose, insulin, active glucagon-like peptide 1 (GLP-1) and nitrotyrosine between different test drinks were compared using linear mixed models. Results showed that only preloading decaffeinated coffee with milk and sugar led to significantly lower glucose incremental AUC (iAUC; 14 % lower, P = 0·001) than water. Preloading black coffees led to greater postprandial glucose iAUC than preloading coffees with milk and sugar added (12-35 % smaller, P < 0·05 for all coffee types). Active GLP-1 and nitrotyrosine levels were not significantly different between test drinks. To conclude, preloading decaffeinated coffee with milk and sugar led to a blunted postprandial glycaemic response after a subsequent high-GI meal, while adding milk and sugar into coffee could mitigate the impairment effect of black coffee towards postprandial glucose responses. These findings may partly explain the positive effects of coffee consumption on glucose metabolism.

Oxyresveratrol Supplementation to C57bl/6 Mice Fed with a High-Fat Diet Ameliorates Obesity-Associated Symptoms.

Oxyresveratrol has been proven effective in inhibiting adipogenesis in a 3T3-L1 cell model. We investigated the preventive effect of oxyresveratrol supplementation on obesity development in high-fat diet-fed mice. Male C57bl/6 mice were randomly subjected to control (5% fat by weight, LF), high-fat (30% fat by weight, HF), and high-fat supplemented with 0.25% and 0.5% oxyresveratrol (OXY1 and OXY2, respectively) diet groups for eight weeks. Oxyresveratrol supplementation effectively alleviated obesity-associated symptoms such as insulin resistance, hyperglycemia, and hepatic steatosis in high-fat diet-fed mice. Compared to the high-fat diet group, oxyresveratrol supplementation suppressed expression of glucose-6-phosphatase, sterol regulatory element-binding proteins 1, fatty acid synthase and CCAAT/Enhancer-binding proteins α, and elevated AMP-activated protein kinase (α2-catalytic subunit) level in liver, upregulated insulin-dependent glucose transporter type 4 level in adipose tissue, and increased expression of insulin receptor substrate 1, insulin-dependent glucose transporter type 4, AMP-activated protein kinase α, peroxisome proliferator-activated receptor γ coactivator-1α, and sirtuin 1 in muscle to regulate lipid and glucose homeostasis in these tissues. This study demonstrated that oxyresveratrol supplementation effectively ameliorated obesity-associated symptoms in high-fat diet-fed mice, presumably attributed to mediating critical regulators involved in lipid and glucose homeostasis in liver, visceral fat, and muscle.

Maternal green tea extract supplementation to rats fed a high-fat diet ameliorates insulin resistance in adult male offspring.

Maternal overnutrition is associated with increased risk of metabolic disorders in the offspring. This study tested the hypothesis that maternal green tea (GT) supplementation can alleviate metabolic derangements in high-fat-diet-fed rats born of obese dams. Female Sprague-Dawley rats were fed low-fat (LF, 7%), high-fat (HF, 30%) or HF diet containing 0.75% or 1.0% GT extract (GT1, GT2) prior to conception and throughout gestation and lactation. Both doses of GT significantly improved metabolic parameters of HF-fed lactating dams (P<.05). Birth weight and litter size of offspring from HF dams were similar, but GT supplementation led to lighter pups on day 21 (P<.05). The weaned male pups received HF, GT1 or GT2 diet (dam/pup diet groups: LF/HF, HF/HF, HF/GT1, HF/GT2, GT1/HF and GT2/HF). At week 13, they had similar weight but insulin resistance index (IRI), serum nonesterified fatty acid (NEFA) and liver triglyceride of rats born to GT dams were 57%, 23% and 26% lower, accompanied by improved gene/protein expressions related to lipid and glucose metabolism, compared with the HF/HF rats (P<.05). Although HF/GT1 and HF/GT2 rats had lower serum NEFA, their insulin and IRI were comparable to HF/HF rats. This study shows that metabolic derangements induced by an overnourished mother could be offset by supplementing GT to the maternal diet and that this approach is more effective than giving GT to offspring since weaning. Hence, adverse effects of developmental programming are reversible, at least in part, by supplementing bioactive food component(s) to the mother's diet.

Supplementation of bitter melon to rats fed a high-fructose diet during gestation and lactation ameliorates fructose-induced dyslipidemia and hepatic oxidative stress in male offspring.

This study examined the impact of maternal high-fructose intake and if metabolic control in the offspring could benefit from supplementing bioactive food components such as bitter melon (BM) to the maternal diet. In Expt. 1, virgin female rats received control (C), high-fructose (F; 60%), or BM-supplemented fructose (FBM; 1%) diet before conception until d 21 of lactation. Weaned male offspring were fed the C diet for 11 wk, forming C/C, F/C, and FBM/C groups. The F/C group had elevated serum insulin, TG, and FFA concentrations and hepatic lipid alterations compared with the C/C and FBM/C groups (P < 0.05). The 2 latter groups did not differ. Expt. 2 had similar dam treatment groups, but offspring were weaned to the C or F diet, forming C/C, C/F, F/F, and FBM/F groups, and the dietary treatment was extended to 20 wk. The hepatic levels of stearyl-CoA desaturase and microsomal TG transfer protein mRNA were lower, but that of PPARγ coactivator 1-α and fibroblast growth factor 21 mRNA and fatty acid binding protein 1 protein were higher in the FBM/F group compared with the C/F and F/F groups (P < 0.05), indicating that maternal BM supplementation may reduce lipogenesis and promote lipid oxidation in offspring. The FBM/F group had significantly higher activities of liver glutathione peroxidase, superoxide dismutase, and catalase than the F/F group. The results indicate that supplementing BM to dams could offset the adverse effects of maternal high-fructose intake on lipid metabolism and antioxidant status in adult offspring.

Beneficial effects of cinnamon proanthocyanidins on the formation of specific advanced glycation endproducts and methylglyoxal-induced impairment on glucose consumption.

Advanced glycation endproducts (AGEs) are a group of complex and heterogeneous compounds formed from nonenzymatic reactions. The accumulation of AGEs in vivo has been implicated as a major pathogenic process in diabetic complications and other health disorders, such as atherosclerosis and Alzheimer's disease, and normal aging. In this study, we investigate the inhibitory effects of cinnamon bark proanthocyanidins, catechin, epicatechin, and procyanidin B2 on the formation of specific AGE representatives including pentosidine, N(epsilon)-(carboxymethyl)lysine (CML), and methylglyoxal (MGO) derived AGEs. These compounds displayed obvious inhibitory effects on these specific AGEs, which are largely attributed to both their antioxidant activities and carbonyl scavenging capacities. Meanwhile, in terms of their potent MGO scavenging capacities, effects of these proanthocyanidins on insulin signaling pathways interfered by MGO were evaluated in 3T3-L1 adipocytes. According to the results, proanthocyanidins exerted protective effects on glucose consumption impaired by MGO in 3T3-L1 fat cells.

Dietary fat concentration influences the effects of trans-10, cis-12 conjugated linoleic acid on temporal patterns of energy intake and hypothalamic expression of appetite-controlling genes in mice.

This study tested the hypothesis that the effect of trans-10, cis-12 conjugated linoleic acid (t10, c12 CLA) on energy intake (EI) and body weight (BW)/composition is confounded by dietary fat concentration and involves hypothalamic appetite-controlling mechanisms. ICR mice received low-fat (LF; 5 g/100 g) or high-fat (HF; 30 g/100 g) diets, with or without 0.5 g/100 g t10, c12 CLA (>98% pure) for 27 d. By d 13, BW and cumulative EI of the mice fed CLA supplemented LF diet (LF/CLA) were 6.6 and 23.6% lower, respectively, than the LF mice. In the subsequent 14 d, their EI rebounded and did not differ from the LF group. BW and EI did not differ between the HF and CLA supplemented HF (HF/CLA) groups. Hypothalamic pro-opiomelanocortin (POMC) mRNA expression was elevated (P = 0.031) on d 13 but suppressed (P < 0.001) on d 27 due to CLA treatment. CLA also suppressed AMP-activated protein kinase alpha2 expression. Mice in Expt. 2 received the LF diet, the LF/CLA, or were pair-fed the LF diet to the EI of the CLA group (LF/PF). LF/CLA and LF/PF mice did not differ in the hypothalamic POMC:neuropeptide Y expression ratio on d 13, but it was significantly lower in the LF/PF group on d 27. We conclude that the habitual dietary fat concentration influences the magnitude of weight loss induced by dietary t10, c12 CLA. The effect is in part independent of EI. Hypothalamic neuropeptides and nutrient sensing mechanisms may play a role.