The FiberTAG project: Tagging dietary fibre intake by measuring biomarkers related to the gut microbiota and their interest for health.

The scientific rationale for dietary fibre intake recommendations comes from the recognition of their benefits for health based on studies first published many years ago. It remains unclear which are the key physiological effects generated by dietary fibre in view of the diversity of the food components considered as dietary fibre, of the relevance of their classification (soluble and insoluble) and from the recent discoveries putting forward their interactions with the gut microbiota. The project FiberTAG (Joint Programming Initiative 'A Healthy Diet for a Healthy Life' 2017-2020 https://www.fibertag.eu/) aims to establish a set of biomarkers (markers of gut barrier function and bacterial co-metabolites including volatile compounds and lipid derivatives), measured in different biological compartments (faeces, blood or breath) linking dietary fibre intake and gut microbiota-related health effects. The FiberTAG consortium brings together academic and industrial partners from Belgium, France, Germany and Canada to share data and samples obtained from existing as well as new intervention studies in order to evaluate the relevance of such biomarkers. The FiberTAG consortium is currently working on five existing cohorts (prospective observational or nutritional interventions in healthy or obese patients), and a number of new intervention studies to analyse the effect of insoluble dietary fibre (wheat bran and chitin-glucan, provided by the industrial partners) in healthy individuals or in obese patients at high cardiometabolic risk.

Analysis of Subjective and Objective Screening Techniques as Predictors of Safety for Radial Artery Intervention.

BACKGROUND: There is no currently accepted standard in safety evaluation for radial artery intervention. We sought to compare the accuracy of various subjective and objective screening techniques in predicting safety for radial artery intervention. METHODS: Fifty-four patients in a prospective cohort study at a single institution underwent subjective Allen's test, objective Barbeau test, and several objective hand ultrasound techniques to assess safety for radial artery intervention. These results were then compared to the gold standard of conventional hand angiography to document complete palmar arch. Statistical analysis including sensitivity, specificity, positive predictive values, negative predictive values, and accuracy were calculated. RESULTS: Compared to hand angiography, the subjective Allen's test and the objective Princeps Pollicis Artery ultrasound demonstrated the comparable levels of sensitivity (100% vs. 96.7%, respectively), specificity (100% vs. 100%, respectively), and accuracy (97.2% vs. 97.1%, respectively). The objective Barbeau test demonstrated similar results (sensitivity of 100%, accuracy of 98.2%) with the exception of a lower specificity (50%). CONCLUSIONS: There is no currently accepted standard in safety evaluation for radial artery intervention. However, preliminary data suggest that certain subjective and objective techniques such as Allen's testing, Princeps Pollicis artery ultrasound, and Barbeau testing are comparable options in predicting palmar arch patency.

Systematic review of the evidence for sustained efficacy of dietary interventions for reducing appetite or energy intake.

We assessed evidence for changes in efficacy of food-based interventions aimed at reducing appetite or energy intake (EI), and whether this could be used to provide guidance on trial design. A systematic search identified randomized controlled trials testing sustained efficacy of diets, foods, supplements or food ingredients on appetite and/or EI. Trials had to include sufficient exposure duration (≥3 days) with appetite and/or EI measured after both acute and repeated exposures. Twenty-six trials met the inclusion criteria and reported data allowing for assessment of the acute and chronic effects of interventions. Most (21/26) measured appetite outcomes and over half (14/26) had objective measures of EI. A significant acute effect of the intervention was retained in 10 of 12 trials for appetite outcomes, and six of nine studies for EI. Initial effects were most likely retained where these were more robust and studies adequately powered. Where the initial, acute effect was not statistically significant, a significant effect was later observed in only two of nine studies for appetite and none of five studies for EI. Maintenance of intervention effects on appetite or EI needs to be confirmed but seems likely where acute effects are robust and replicable in adequately powered studies.

Late Incomplete stent apposition is associated with late/very late stent thrombosis: A meta-analysis.

BACKGROUND: There is a lingering controversy in the current literature about the impact of late incomplete stent apposition (LISA) on clinical outcomes, especially stent thrombosis (ST). Therefore, we aimed to synthesize the available evidence evaluating the association between LISA and adverse clinical outcomes. METHODS: We systematically searched electronic databases for studies reporting clinical outcomes in patients with and without LISA. Relevant study characteristics and clinical outcomes were extracted. Incidence rate ratios (IRR) and 95% Confidence Interval (CI) were computed. Sensitivity analyses were done. RESULTS: Sixteen studies with 4,946 patients; 666 patients with 20,035 patient-months follow up with LISA and 4,280 patients with 121,855 patient-months follow up without LISA were included. The estimated prevalence of LISA at follow up was 16% (95% CI 12-20%). The incidences of late/very late ST (IRR = 4.81, 95% CI 2.68-8.62) and myocardial infarction (MI) (IRR = 3.09, 95% CI 1.72-5.55) were significantly higher in the LISA group compared to patients without LISA. Subset analysis of studies reporting Academic Research Consortium definitive/probable ST (IRR = 4.98; 95% CI 2.51-9.89) and acquired LISA (IRR = 3.67, 95% CI 1.5-9.0) similarly showed increased risk of late/very late ST. The results of sensitivity analyses were consistent. There was no difference in cardiac death and target lesion revascularization. CONCLUSION: The presence of LISA at a follow up of 6-18 months after stent implantation is associated with a higher risk of late/very late ST and MI. Additional studies are required to establish a cause and effect, and inform the management strategy. © 2017 Wiley Periodicals, Inc.

Plasma glucose kinetics and response of insulin and GIP following a cereal breakfast in female subjects: effect of starch digestibility.

BACKGROUND/OBJECTIVES: Foods with high contents of slowly digestible starch (SDS) elicit lower glycemic responses than foods with low contents of SDS but there has been debate on the underlying changes in plasma glucose kinetics, that is, respective contributions of the increase in the rates of appearance and disappearance of plasma glucose (RaT and RdT), and of the increase in the rate of appearance of exogenous glucose (RaE) and decrease in endogenous glucose production (EGP). SUBJECTS/METHODS: Sixteen young healthy females ingested in random order four types of breakfasts: an extruded cereal (0.3% SDS: Lo-SDS breakfast) or one of three biscuits (39-45% SDS: Hi-SDS breakfasts). The flour in the cereal products was labeled with (13)C, and plasma glucose kinetics were measured using [6,6-(2)H2]glucose infusion, along with the response of plasma glucose, insulin and glucose-dependent insulinotropic peptide (GIP) concentrations. RESULTS: When compared with the Lo-SDS breakfast, after the three Hi-SDS breakfasts, excursions in plasma glucose, the response of RaE, RaT and RdT, and the reduction in EGP were significantly lower (P<0.05). The amount of exogenous glucose absorbed over the 4.5-h postprandial period was also significantly lower by ~31% (P<0.001). These differences were associated with lower responses of GIP and insulin concentrations. CONCLUSIONS: Substituting extruded cereals with biscuits slows down the availability of glucose from the breakfast and its appearance in peripheral circulation, blunts the changes in plasma glucose kinetics and homeostasis, reduces excursions in plasma glucose, and possibly distributes the glucose ingested over a longer period following the meal.

Impact of postprandial glycaemia on health and prevention of disease.

Postprandial glucose, together with related hyperinsulinemia and lipidaemia, has been implicated in the development of chronic metabolic diseases like obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In this review, available evidence is discussed on postprandial glucose in relation to body weight control, the development of oxidative stress, T2DM, and CVD and in maintaining optimal exercise and cognitive performance. There is mechanistic evidence linking postprandial glycaemia or glycaemic variability to the development of these conditions or in the impairment in cognitive and exercise performance. Nevertheless, postprandial glycaemia is interrelated with many other (risk) factors as well as to fasting glucose. In many studies, meal-related glycaemic response is not sufficiently characterized, or the methodology with respect to the description of food or meal composition, or the duration of the measurement of postprandial glycaemia is limited. It is evident that more randomized controlled dietary intervention trials using effective low vs. high glucose response diets are necessary in order to draw more definite conclusions on the role of postprandial glycaemia in relation to health and disease. Also of importance is the evaluation of the potential role of the time course of postprandial glycaemia.

Endothelin as a clinical target in the treatment of systemic hypertension.

Endothelin is a potent vasoconstrictor substance that also can exert proliferative, inflammatory, and fibrotic changes in blood vessels and other organs. It acts on tissues in a paracrine and autocrine fashion, with local production and regulation occurring in both endothelial and nonendothelial cells. Endothelin stimulation of ETA and ETB receptors results in different and often opposing effects, which under physiologic conditions, establishes a balance that contributes to the regulation of vascular tone and blood pressure. Dysregulation of the endothelin system can induce or mediate endothelial dysfunction and organ damage in systemic hypertension (HTN), effects which may be ameliorated by endothelin antagonists. Endothelin receptor antagonists are currently being used in the treatment of pulmonary HTN. Both selective and dual-acting endothelin receptor blockers can also reduce systemic blood pressure in animal models and in hypertensive patients. Clinical trials evaluating the efficacy and safety of these agents are underway, and show potential as a new class of antihypertensives. Studies are also in progress with a single moiety dual angiotensin-endothelin A receptor antagonist, which is being evaluated in HTN. Issues that need to be addressed include the net contribution of endothelin in the pathophysiology of HTN, its interaction with other neurohormonal systems such as the renin-angiotensin-aldosterone system, and the clinical demonstration of the effect of endothelin receptor antagonism on end-organ damage in hypertensive patients.

The relationship between areca nut usage and heart rate in lactating Bangladeshis.

BACKGROUND: The betel-nut quid, a piece of areca nut chewed alone or mixed with tobacco and slaked lime wrapped in betel vine leaf, is widely used in Asian populations as a stimulant (due to the cholinergic agent, arecoline) or as a relaxant (due to arecaidine and guvacine). OBJECTIVES: This study, which formed part of a larger project assessing the effect of energy expenditure on the duration of post-partum amenorrhoea, provided the opportunity to assess the role of chronic areca nut usage on heart rate and oxygen consumption during resting periods and during graded stepping tests. SUBJECTS AND METHODS: The mothers (n = 47), all of whom were lactating, were aged between 19 and 39, of low nutritional status and anaemic and they all chewed betel quid daily. RESULTS: Moderate users of betel quid (defined as more than 3 times a day) were found, on average, to have a significantly lower heart rate at rest and during exercise than low betel quid users (less than 3 times a day) but there was no modification in oxygen consumption. CONCLUSION: Chronic betel quid use does not seem to affect the assessment of 24h energy expenditure provided that subjects are denied access to betel nut usage before and during calibration.

Repeated measurements of energy intake, energy expenditure and energy balance in lactating Bangladeshi mothers.

OBJECTIVE: To examine changes in energetic parameters and nutritional status of chronically malnourished lactating women over a period of 13 months postpartum. DESIGN: A study of 15 lactating Bangladeshi mothers, of whom eight were tea pluckers and seven housewives, was conducted over a 13 months period from the birth of the child. Anthropometric measurements and body composition were determined on five occasions (at 3.5, 5.5, 7.5, 10 and 13 months) and energy expenditure (heart rate monitoring method), and energy intake (3-day weighing) on three occasions at 3.5, 10 and 13 months. RESULTS: The mothers, all of whom were of low BMI (range 14.9-18.1 kg/m2 at the end of the study) undertook high levels of physical activity (pluckers more so than housewives). There was evidence of weight loss over the 13 months, particularly between the fourth and sixth months postpartum, mainly due to a significant decrease in fat-free mass. Food intake and expenditure were higher in pluckers than housewives but energy balance was not significantly different, although workers were, on average, in negative balance on all three occasions. Food intake was based on cereals and fat deficient. CONCLUSIONS: A Bangladeshi sample of breast-feeding mothers studied over 13 months postpartum showed evidence of chronic malnutrition with women living on very low fat diets. All mothers, either housewives or tea pluckers were involved in energy demanding activities. There was a general tendency towards negative energy balance. Mothers lost weight, mainly fat-free mass over the study period.