Sensory Interactions between Sweetness and Fat in a Chocolate Milk Beverage.

Fat and sugar-reduced foods and beverages have become increasingly popular for a variety of reasons, mainly relating to health and wellbeing. Depending on the food or beverage, it may be difficult to reduce the fat and/or sugar content and still maintain optimal sensory properties for the specific product. One way of approaching the problem is to gain a better understanding of how a product is affected by a reduction in fat and/or sugar. This paper aims to investigate the sensory interactions between fat and sweetness perception in a chocolate-flavored milk beverage by using a descriptive analysis with a trained sensory panel. The reduction of fat significantly reduced the sweetness intensity of the chocolate milk, while the reduction of sucrose significantly decreased the cream flavor and the fruity and lactic flavor. The perception of acesulfame-K was affected by fat concentration, similarly to sucrose. These results highlight the importance of considering the effects of reducing either sugar and fat on product attributes that are not directly related to the sugar or fat.

Microbial interaction: Prevotella spp. reduce P. aeruginosa induced inflammation in cystic fibrosis bronchial epithelial cells.

BACKGROUND: In Cystic Fibrosis (CF) airways, the dehydrated, thick mucus promotes the establishment of persistent polymicrobial infections and drives chronic airways inflammation. This also predisposes the airways to further infections, the vicious, self-perpetuating cycle causing lung damage and progressive lung function decline. The airways are a poly-microbial environment, containing both aerobic and anaerobic bacterial species. Pseudomonas aeruginosa (P. aeruginosa) infections contribute to the excessive inflammatory response in CF, but the role of anaerobic Prevotella spp., frequently found in CF airways, is not known. MATERIALS: We assessed innate immune signalling in CF airway epithelial cells in response to clinical strains of P. histicola, P. nigresens and P. aeruginosa. CFBE41o- cells were infected with P. aeruginosa (MOI 100, 2h) followed by infection with P. histicola or P. nigrescens (MOI 100, 2h). Cells were incubated under anaerobic conditions for the duration of the experiments. RESULTS: Our study shows that P. histicola and P. nigresens can reduce the growth of P. aeruginosa and dampen the inflammatory response in airway epithelial cells. We specifically illustrate that the presence of the investigated Prevotella spp. reduces Toll-like-receptor (TLR)-4, MAPK, NF-κB(p65) signalling and cytokine release (Interleukin (IL)-6, IL-8) in mixed infections. CONCLUSION: Our work, for the first time, strongly indicates a relationship between P. aeruginosa and anaerobic Prevotella spp.. The observed modified NF-κB and MAPK signalling indicates some mechanisms underlying this interaction that could offer a novel therapeutic approach to combat chronic P. aeruginosa infection in people with CF.

Toll like Receptor signalling by Prevotella histicola activates alternative NF-κB signalling in Cystic Fibrosis bronchial epithelial cells compared to P. aeruginosa.

Cystic Fibrosis (CF), caused by mutations affecting the CFTR gene, is characterised by viscid secretions in multiple organ systems. CF airways contain thick mucus, creating a gradient of hypoxia, which promotes the establishment of polymicrobial infection. Such inflammation predisposes to further infection, a self-perpetuating cycle in mediated by NF-κB. Anaerobic Gram-negative Prevotella spp. are found in sputum from healthy volunteers and CF patients and in CF lungs correlate with reduced levels of inflammation. Prevotella histicola (P. histicola) can suppress murine lung inflammation, however, no studies have examined the role of P. histicola in modulating infection and inflammation in the CF airways. We investigated innate immune signalling and NF-kB activation in CF epithelial cells CFBE41o- in response to clinical stains of P. histicola and Pseudomonas aeruginosa (P. aeruginosa). Toll-Like Receptor (TLR) expressing HEK-293 cells and siRNA assays for TLRs and IKKα were used to confirm signalling pathways. We show that P. histicola infection activated the alternative NF-kB signalling pathway in CF bronchial epithelial cells inducing HIF-1α protein. TLR5 signalling was responsible for the induction of the alternative NF-kB pathway through phosphorylation of IKKα. The induction of transcription factor HIF-1α was inversely associated with the induction of the alternative NF-kB pathway and knockdown of IKKα partially restored canonical NF-kB activation in response to P. histicola. This study demonstrates that different bacterial species in the respiratory microbiome can contribute differently to inflammation, either by activating inflammatory cascades (P. aeruginosa) or by muting the inflammatory response by modulating similar or related pathways (P. histicola). Further work is required to assess the complex interactions of the lung microbiome in response to mixed bacterial infections and their effects in people with CF.

Taste Interactions between Sweetness of Sucrose and Sourness of Citric and Tartaric Acid among Chinese and Danish Consumers.

Tastes interact in almost every consumed food or beverage, yet many aspects of interactions, such as sweet-sour interactions, are not well understood. This study investigated the interaction between sweetness from sucrose and sourness from citric and tartaric acid, respectively. A cross-cultural consumer study was conducted in China (n = 120) and Denmark (n = 139), respectively. Participants evaluated six aqueous samples with no addition (control), sucrose, citric acid, tartaric acid, or a mixture of sucrose and citric acid or sucrose and tartaric acid. No significant difference was found between citric acid and tartaric acid in the suppression of sweetness intensity ratings of sucrose. Further, sucrose suppressed sourness intensity ratings of citric acid and tartaric acid similarly. Culture did not impact the suppression of sweetness intensity ratings of citric or tartaric acid, whereas it did influence sourness intensity ratings. While the Danish consumers showed similar suppression of sourness by both acids, the Chinese consumers were more susceptible towards the sourness suppression caused by sucrose in the tartaric acid-sucrose mixture compared to the citric acid-sucrose mixture. Agglomerative hierarchical cluster analysis revealed clusters of consumers with significant differences in sweetness intensity ratings and sourness intensity ratings. These results indicate that individual differences in taste perception might affect perception of sweet-sour taste interactions, at least in aqueous solutions.

Ternary Cross-Modal Interactions between Sweetness, Aroma, and Viscosity in Different Beverage Matrices.

Sugar reduction in food and beverage products involves several challenges. Non-nutritive sweeteners may give unwanted off-flavors, while sugar-reduced products often lack mouthfeel. To overcome this, the addition of aroma to increase sweetness through cross-modal interactions, and the addition of hydrocolloids such as pectin to increase viscosity, have been suggested as strategies to aid sugar reduction. However, viscosity has been shown to decrease both taste and aroma intensities. An increase in viscosity may thereby affect the use of aromas as sweetness enhancers. Additionally, the effects of aromas and hydrocolloids on sweetness intensity and mouthfeel depend on the food matrix involved. The present study investigated cross-modal aroma-sweetness-viscosity interactions in two beverage matrices: water and apple nectar. The perceptual effects of vanilla aroma (0-1 mL/kg), sucrose (2.5%-7.5% w/w) and pectin (0%-0.3% w/w) were studied in both matrices. For each matrix, cross-modal interactions were analyzed with descriptive analysis using a trained sensory panel. The effect of vanilla aroma on sweetness intensity was found to be higher in apple nectar compared to in water. Furthermore, pectin affected neither taste, aroma, nor the cross-modal effects of aroma on taste in either of the matrices. These results indicate that pectin, in the studied range of concentrations, may be used to improve mouthfeel in sugar-reduced beverages, without compromising taste or aroma perception.

Sweetness Enhancement by Aromas: Measured by Descriptive Sensory Analysis and Relative to Reference Scaling.

Sweetness enhancement by aromas has been suggested as a strategy to mitigate sugar reduction in food products, but enhancement is dependent on type of aroma and sugar level. A careful screening of aromas across sugar levels is thus required. Screening results might, however, depend on the method employed. Both descriptive sensory analysis and relative to reference scaling were therefore used to screen 5 aromas across 3 sucrose concentrations for their sweetness-enhancing effects in aqueous solutions. In the descriptive analysis, samples with added vanilla, honey, and banana aroma were rated as significantly sweeter than samples with added elderflower or raspberry aroma at all sucrose concentrations. In relative to reference scaling, honey aroma significantly increased the sweet taste compared with samples with added elderflower or no aroma at low and medium sucrose concentrations. Banana and raspberry aromas also increased the sweet taste significantly compared with the sample with added elderflower aroma at medium sucrose concentration in the relative to reference scaling. This demonstrates that the cross-modal effects observed by the 2 methods were different. In terms of the methods applied, relative to reference scaling was generally found to result in a decrease in the measured sweetness enhancement by aromas. In the descriptive analysis, the cross-modal effect of aromas on sweet taste perception was found to be significantly higher at 2.5% and 5.0% w/w sucrose compared with 7.5% w/w sucrose. These results highlight the importance of considering how references are employed in sensory analysis and how they affect cross-modal interactions.

Individual Differences in Sweetness Ratings and Cross-Modal Aroma-Taste Interactions.

Aroma-taste interactions, which are believed to occur due to previous coexposure (concurrent presence of aroma and taste), have been suggested as a strategy to aid sugar reduction in food and beverages. However, coexposures might be influenced by individual differences. We therefore hypothesized that aroma-taste interactions vary across individuals. The present study investigated how individual differences (gender, age, and sweet liker status) influenced the effect of aroma on sweetness intensity among young adults. An initial screening of five aromas, all congruent with sweet taste, for their sweetness enhancing effect was carried out using descriptive analysis. Among the aromas tested, vanilla was found most promising for its sweet enhancing effects and was therefore tested across three sucrose concentrations by 129 young adults. Among the subjects tested, females were found to be more susceptible to the sweetness enhancing effect of vanilla aroma than males. For males, the addition of vanilla aroma increased the sweet taste ratings significantly for the 22-25-year-olds, but not the 19-21-year-olds. Consumers were clustered according to their sweet liker status based on their liking for the samples. Although sweet taste ratings were found to vary with the sweet liker status, aroma enhanced the sweetness ratings similarly across clusters. These results call for more targeted product development in order to aid sugar reduction.

The Role of Intrinsic and Extrinsic Sensory Factors in Sweetness Perception of Food and Beverages: A Review.

When it comes to eating and drinking, multiple factors from diverse sensory modalities have been shown to influence multisensory flavour perception and liking. These factors have heretofore been strictly divided into either those that are intrinsic to the food itself (e.g., food colour, aroma, texture), or those that are extrinsic to it (e.g., related to the packaging, receptacle or external environment). Given the obvious public health need for sugar reduction, the present review aims to compare the relative influences of product-intrinsic and product-extrinsic factors on the perception of sweetness. Evidence of intrinsic and extrinsic sensory influences on sweetness are reviewed. Thereafter, we take a cognitive neuroscience perspective and evaluate how differences may occur in the way that food-intrinsic and extrinsic information become integrated with sweetness perception. Based on recent neuroscientific evidence, we propose a new framework of multisensory flavour integration focusing not on the food-intrinsic/extrinsic divide, but rather on whether the sensory information is perceived to originate from within or outside the body. This framework leads to a discussion on the combinability of intrinsic and extrinsic influences, where we refer to some existing examples and address potential theoretical limitations. To conclude, we provide recommendations to those in the food industry and propose directions for future research relating to the need for long-term studies and understanding of individual differences.

See, Feel, Taste: The Influence of Receptacle Colour and Weight on the Evaluation of Flavoured Carbonated Beverages.

A study was designed to assess whether the individual and combined effects of product-intrinsic and product-extrinsic factors influence the perception of, and liking for, carbonated beverages. Four hundred and one participants tasted samples of one of three flavours (grapefruit, lemon, or raspberry) of carbonated aromatised non-alcoholic beer. The beverages were served in receptacles that differed in terms of their colour (red or black) and weight (lighter-no added weight, or heavier-20 g weight added). Each participant received the same beverage in each of the four different receptacles, and rated how much they liked the drink. They also evaluated the intensity of each beverage's sweetness, bitterness, sourness, and carbonation. The results revealed a significant influence of the colour of the receptacle on perceived carbonation, with the beverages tasted from the red receptacles being rated as tasting more carbonated than when served in black receptacles. In terms of flavour, the participants liked the raspberry beverage significantly more than the others, while also rating it as tasting sweeter and less bitter than either of the other flavours. Furthermore, there was a more complex interaction effect involving the weight of the receptacle: Specifically, the perceived bitterness of the beverage moderated the relationship between the receptacle weight and the perceived carbonation. At high levels of bitterness, the drinks were perceived to be more carbonated when served from the heavier receptacle as compared to the lighter one. These findings highlight the complex interplay of product extrinsic and intrinsic factors on the flavour/mouthfeel perception and preference for beverages, and stress the importance of taking both internal product development and external packaging into account in the design of health-oriented beverages.

Bitter taste masking of enzyme-treated soy protein in water and bread.

BACKGROUND: Bioactive protein hydrolysates are often very bitter. To overcome this challenge, xylitol, sucrose, α-cyclodextrin, maltodextrin and combinations of these were tested systematically as bitter-masking agents of an enzyme-treated soy protein in an aqueous model and in a bread model. Sensory descriptive analysis was used to reveal the bitter-masking effect of the taste-masking blends on the enzyme-treated soy protein. RESULTS: In water, xylitol, sucrose and maltodextrin reduced bitterness significantly, whereas α-cyclodextrin did not. No significant difference was observed in bitterness reduction between xylitol and sucrose. Both reduced bitterness significantly more than maltodextrin. No interactions between the taste-masking agents affecting bitterness reduction were found. Clearer bitter-masking effects were seen in the aqueous model compared with the bread model. The bitter-masking effects of α-cyclodextrin and maltodextrin were similar between water and bread. The effect of xylitol and sucrose on bitterness suppression varied between the systems. In water, bitterness was negatively correlated with sweetness. In bread, bitterness was negatively correlated with freshness, and maltodextrin significantly reduced bitterness of the enzyme-treated soy protein and increased freshness. CONCLUSION: Bitter-masking effects were generally more discernible in the aqueous model compared with the bread model. © 2018 Society of Chemical Industry.

Whole-Body 18F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients.

A fast-track pathway has been established in Denmark to investigate patients with serious nonspecific symptoms and signs of cancer (NSSC), who are not eligible to enter an organ-specific cancer program. The prevalence of cancer in this cohort is approximately 20%. The optimal screening strategy in patients with NSSC remains unknown. The aim of the study was to investigate whether 18F-FDG PET/CT was superior to CT as an initial imaging modality in patients with NSSC. In a randomized prospective trial, the imaging modalities were compared with regard to diagnostic performance. Methods: Two hundred patients were randomized 1:1 to whole-body 18F-FDG PET/CT or CT of the thorax and abdomen as the imaging modality. A tentative diagnosis was established after first-line imaging. The final referral diagnosis was adjudicated by the physician, when sufficient data were available. Results: One hundred ninety-seven patients were available for analysis because 3 patients withdrew consent before scanning. Thirty-nine (20%) patients were diagnosed with cancer, 10 (5%) with an infection, 15 (8%) with an autoimmune disease, and 76 (39%) with other diseases. In the remaining 57 patients (28%), no specific disease was found. 18F-FDG PET/CT had a higher specificity (96% vs. 85%; P = 0.028) and a higher accuracy (94% vs. 82%; P = 0.017) than CT. However, there were no statistically significant differences in sensitivity (83% vs. 70%) or negative predictive values (96% vs. 92%). No difference in days to final referral diagnosis according to randomization group could be shown (7.2 vs. 7.6 d). However, for the subgroups in which the imaging modality showed a suggestion of malignancy, there was a significant delay to final diagnosis in the CT group compared with the 18F-FDG PET/CT group (11.6 vs. 5.7 d; P = 0.02). Conclusion: Compared with CT, we found a higher diagnostic specificity and accuracy of 18F-FDG PET/CT for detecting cancer in patients with NSSC. 18F-FDG PET/CT should therefore be considered as first-line imaging in this group of patients.

Botulinum Toxin as Monotherapy in Symptomatic Trigeminal Neuralgia.

BACKGROUND: Trigeminal neuralgia (TN) is one of the most agonizing facial pain disorders that humans endure. Studies on onabotulinum toxin A (BTX-A) treatment for TN are limited, but promising with respect to TN of no identifiable cause. We aimed to investigate the efficiency and safety of BTX-A treatment in a 60-year-old male with diabetes mellitus who in March 2013 presented with TN caused by an exostosis in Meckel's cave. METHODS: The patient was medically treatment refractory due to insufficient pain relief and adverse events of hyperglycemia, and surgery was declined due to complex anatomy. As a last resort, BTX-A was injected into the pain trigger zones of the trigeminal nerve (V5). RESULTS: Complete analgesia was reported 2 weeks after BTX-A injection. Pain medications were discontinued and laboratory values returned to acceptable levels. Regular BTX-A treatment during the next 28 months showed sustained analgesic effect. CONCLUSIONS: BTX-A has an excellent safety profile and may be efficient for patients with symptomatic TN not suited for conventional therapies.

Focal myositis--neurogenic phenomenon?

We report four cases of focal myositis. The patients, three men and one woman, had painful muscle hypertrophy, affecting four different sites. MRI confirmed the muscle enlargement and oedema. Electromyography revealed evidence of acute and chronic denervation in all four cases. Muscle biopsy was available in three and confirmed features suggestive of focal myositis. Based on our patient material, we suggest that chronic nerve irritation, such as compression, can lead to muscle hypertrophy which, when prolonged, provokes fibre necrosis and secondary inflammation. Our finding in four patients having hypertrophy involving four different sites, leads us further to suggest that this may be the common mechanism behind focal myositis.

Multimodality approach to mediastinal staging in non-small cell lung cancer. Faults and benefits of PET-CT: a randomised trial.

BACKGROUND: Correct mediastinal staging is a cornerstone in the treatment of patients with non-small cell lung cancer. A large range of methods is available for this purpose, making the process of adequate staging complex. The objective of this study was to describe faults and benefits of positron emission tomography (PET)-CT in multimodality mediastinal staging. METHODS: A randomised clinical trial was conducted including patients with a verified diagnosis of non-small cell lung cancer, who were considered operable. Patients were assigned to staging with PET-CT (PET-CT group) followed by invasive staging (mediastinoscopy and/or endoscopic ultrasound with fine needle aspiration (EUS-FNA)) or invasive staging without prior PET-CT (conventional work up (CWU) group). Mediastinal involvement (dichotomising N stage into N0-1 versus N2-3) was described according to CT, PET-CT, mediastinoscopy, EUS-FNA and consensus (based on all available information), and compared with the final N stage as verified by thoracotomy or a conclusive invasive diagnostic procedure. RESULTS: A total of 189 patients were recruited, 98 in the PET-CT group and 91 in the CWU group. In an intention-to-treat analysis the overall accuracy of the consensus N stage was not significantly higher in the PET-CT group than in the CWU group (90% (95% confidence interval 82% to 95%) vs 85% (95% CI 77% to 91%)). Excluding the patients in whom PET-CT was not performed (n=14) the difference was significant (95% (95% CI 88% to 98%) vs 85% (95% CI 77% to 91%), p=0.034). This was mainly based on a higher sensitivity of the staging approach including PET-CT. CONCLUSION: An approach to lung cancer staging with PET-CT improves discrimination between N0-1 and N2-3. In those without enlarged lymph nodes and a PET-negative mediastinum the patient may proceed directly to surgery. However, enlarged lymph nodes on CT needs confirmation independent of PET findings and a positive finding on PET-CT needs confirmation before a decision on surgery is made. CLINICAL TRIAL NUMBER: NCT00867412.

Preoperative staging of lung cancer with combined PET-CT.

BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC. METHODS: We randomly assigned patients who were referred for preoperative staging of NSCLC to either conventional staging plus PET-CT or conventional staging alone. Patients were followed until death or for at least 12 months. The primary end point was the number of futile thoracotomies, defined as any one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause within 1 year after randomization. RESULTS: From January 2002 through February 2007, we randomly assigned 98 patients to the PET-CT group and 91 to the conventional-staging group. Mediastinoscopy was performed in 94% of the patients. After PET-CT, 38 patients were classified as having inoperable NSCLC, and after conventional staging, 18 patients were classified thus. Sixty patients in the PET-CT group and 73 in the conventional-staging group underwent thoracotomy (P=0.004). Among these thoracotomies, 21 in the PET-CT group and 38 in the conventional-staging group were futile (P=0.05). The number of justified thoracotomies and survival were similar in the two groups. CONCLUSIONS: The use of PET-CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies but did not affect overall mortality. (ClinicalTrials.gov number, NCT00867412.)

Stimulation of spinal 5-HT(2A/2C) receptors potentiates the capsaicin-induced in vivo release of substance P-like immunoreactivity in the rat dorsal horn.

Stimulation of spinal serotonin (5-HT)(2A/2C) receptors has previously been reported to lead to either a pro-nociceptive or an anti-nociceptive response. Behavioral data have indicated that the pro-nociceptive effect is related to the release of substance P (SP). The aim of this in vivo microdialysis study was to investigate if stimulation of spinal 5-HT(2A/2C) receptors by the selective agonist (+/-)-2,5-dimethoxy-4-iodoamphetamine (DOI) induces spontaneous or capsaicin-evoked increase in the release of SP-like immunoreactivity (SP-LI) in the rat dorsal horn. A dose of capsaicin (25 microM in the perfusion medium administered for 30 min), which did not lead to a significant release of SP-LI on its own, induced a significant increase of greater than 4-fold of the SP-LI level following spinal application of 50 nmol DOI. Higher (500 nmol) or lower (5 nmol) doses of DOI failed to induce a similar effect. In rats with a peripheral inflammation, induced by carrageenan, capsaicin (25 microM) induced a non-significant increase of SP-LI. A significant 8-fold increase of the SP-LI level was detected following administration of 50 nmol DOI in combination with capsaicin. The effect of DOI, which was completely prevented by co-administration of the 5-HT(2A) receptor antagonist ketanserin in control animals without peripheral inflammation, was only partly blocked in animals with carrageenan induced peripheral inflammation. In conclusion, stimulation of 5-HT(2A/2C) receptors facilitates the capsaicin-evoked release of SP-LI in the dorsal horn in both animals with and without carrageenan-induced unilateral inflammation. The observation that the highest dose of DOI failed to induce SP-LI release may be due to an inhibitory postsynaptic action at this dose.