Consumption of sourdough bread and changes in the glycemic control and satiety: A systematic review.

The aim of this study was to carry out a systematic review of clinical trials followed by meta-analysis, to evaluate the effect of sourdough bread on glycemic control and appetite and satiety regulators such as leptin, ghrelin, GLP-1 (glucagon-like peptide-1), GLP-2 (glucagon-like peptide-2), NPY (neuropeptide Y), AgRP (agouti-related protein), PYY (peptide YY), and GIP (glucose-dependent insulinotropic polypeptide). Clinical trials compared the intake of sourdough bread to that of an industrially fermented one or control glucose solution in adults over 18 years of age. This systematic review included all randomized, parallel, or crossover trials published up to June 2021 in the EMBASE, MEDLINE, Scopus, and Web of Science databases. After the selection process, 18 studies were included. The analysis of the final average difference of the change in serum glucose after 60 minutes for the intervention indicated that the consumption of sourdough bread has a lower impact on blood glucose compared to that of industrial bread or glucose (MD = -0.29, IC 95% = [-0.46; -0.12]; I2 = 0%). The evaluation of blood glucose 120 minutes after the consumption of the intervention also indicated a lower increment in blood glucose when compared to the consumption of other types of bread or the same amount of glucose (MD = -0.21, IC 95% = [-0.32; -0.09]; I2 = 0%). The certainty of evidence varied from low to very low. The results showed that sourdough is effective in reducing the increment of postprandial glycemia, especially when prepared with whole wheat flour, although it does not reduce fasting serum insulin, nor does it change plasma PYY.

Consumption of school meals provided by PNAE among brazilian public school adolescents / Consumo de comidas escolares proporcionadas por PNAE entre adolescentes de escuelas públicas brasileñas

ABSTRACT Objective: Assess adherence to school food offered by the School Food Program (Programa Nacional de Alimentação Escolar - PNAE) and the associated factors among Brazilian adolescents. Methods: Cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents conducted in 2013-2014, with 58,707 adolescents aged 12 to 17 years-old who attended public schools. Logistic regression models were stratified by sex and the significance level of 5% was adopted for all analyses. Results: There was low adherence to school meals (17.2%). The chance of regular consumption of school meals was higher among male adolescents belonging to the medium (p<0.05) and the low (p<0.05) socioeconomic score categories. For females, the chance of regular consumption of food offered at school was higher among black-skinned, brown-skinned, indigenous-skinned or yellow-skinned adolescents (p<0.05), aged 16 and 17 (p<0.05), who worked (p<0.001) and belonged to the medium (p<0.05) and low (p<0.05) socioeconomic score categories. The regular purchase of food in school cafeterias reduced the chance of regular consumption of school meals for males (p<0.001) and females (p<0.001). Conclusions: Adherence to the food offered by the PNAE is far from ideal, and it is important to create public policies that encourage the consumption of school meals and improve adherence. In addition, the strengthening and drafting of regulations aimed at the sale of food in the interior and surrounding schools' areas is necessary.

RESUMEN Objetivo: Evaluar la adherencia a la comida escolar ofrecida por el Programa Nacional de Alimentación Escolar y los factores asociados entre los adolescentes brasileños. Métodos: Estudio transversal con datos del Estudio de Riesgos Cardiovasculares en Adolescentes realizado en 2013-2014, con 58.707 adolescentes de 12 a 17 años que asistieron a escuelas públicas. Los modelos de regresión logística se realizaron estratificados por sexo, y se aplicó el nivel de significancia del 5% para todos los análisis. Resultados: Hubo baja adherencia a las comidas escolares (17,2%). La posibilidad de consumo regular de comidas escolares fue mayor entre los adolescentes varones pertenecientes a las categorías de puntaje socioeconómico medio (p<0,05) y bajo (p<0,05). Para las mujeres, la probabilidad de consumo regular de alimentos ofrecidos en la escuela fue mayor entre las adolescentes de piel negra, marrón, indígena o amarilla (p<0,05), de 16 y 17 años (p<0,05), quién trabaja (p<0,001) y pertenece a las categorías de puntaje socioeconómico medio (p<0,05) y bajo (p<0,05). La compra regular de alimentos en las cafeterías escolares redujo la posibilidad de consumo regular de comidas escolares para hombres (p<0,001) y mujeres (p<0,001). Conclusiones: La adhesión a los alimentos ofrecidos por el PNAE está lejos de ser ideal, y es importante crear políticas públicas que fomenten el consumo de comidas escolares, mejoren su adherencia, además de ayudar en el fortalecimiento y la redacción de regulaciones dirigidas a la venta de alimentos en el interior y las áreas de las escuelas circundantes.