Fortifying a meal with oyster mushroom powder beneficially affects postprandial glucagon-like peptide-1, non-esterified free fatty acids and hunger sensation in adults with impaired glucose tolerance: a double-blind randomized controlled crossover trial.

PURPOSE: Impaired glucose tolerance (IGT) is a pathophysiological condition characterized by insulin resistance with known metabolic consequences such as postprandial hyperglycemia and hypertriglyceridemia. We hypothesized that fortifying a meal with mushrooms rich in ß-glucans may diminish glucose and triglyceride responses by improving postprandial gastrointestinal hormone release. METHODS: In a randomized controlled crossover study, 22 subjects with IGT ingested a meal either enriched with 20 g powder (8.1 g ß-glucans) of oven-dried Pleurotus ostreatus (enriched meal, EN) or without enrichment (control meal, CON). Blood was collected before and repeatedly within 4 h after the meal to determine AUC of glucose (primary outcome), insulin, triglycerides, non-esterified free fatty acids (NEFAs), glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP) and ghrelin. Appetite sensations (hunger, satiety, fullness, and desire to eat) were assessed before and after meal consumption by visual analog scales. RESULTS: Postprandial glucose, insulin, triglycerides, GIP and ghrelin concentrations as well as the corresponding AUCs did not differ between EN and CON. NEFAs-AUC was 14% lower (P = 0.026) and GLP-1-AUC 17% higher (P = 0.001) after EN compared to CON. Appetite ratings did not differ between treatments, except for hunger (AUC 22% lower after EN vs. CON; P = 0.031). CONCLUSION: The observed immediate postprandial metabolic changes indicate that an easily manageable fortification of a single meal with powder from dried oyster mushrooms as ß-glucan source may improve postprandial metabolism. If the effect is preserved long term, this measure can diminish the risk for further development of overweight/obesity and type 2 diabetes in subjects with IGT. CLINICAL TRIAL REGISTRATION: German Clinical Trial Register on 09/08/2018; trial-ID: DRKS00015244.

Low Plasma Appearance of (+)-Catechin and (-)-Catechin Compared with Epicatechin after Consumption of Beverages Prepared from Nonalkalized or Alkalized Cocoa-A Randomized, Double-Blind Trial.

Flavan-3-ols are claimed to be responsible for the cardioprotective effects of cocoa. Alkalized cocoa powder (ALC), commonly used for many non-confectionary products, including beverages, provides less (+)-catechin, (-)-epicatechin, and procyanidins and more (-)-catechin than nonalkalized cocoa powder (NALC). This may affect the plasma appearance of monomeric flavan-3-ol stereoisomers after consumption of NALC vs. ALC. Within a randomized, crossover trial, 12 healthy nonsmokers ingested a milk-based cocoa beverage providing either NALC or ALC. Blood was collected before and within 6 h postconsumption. (+)-Catechin, (-)-catechin, and epicatechin were analyzed in plasma by HPLC as sum of free and glucuronidated metabolites. Pharmacokinetic parameters were obtained by a one-compartment model with nonlinear regression methods. For epicatechin in plasma, total area under the curve within 6 h postconsumption (AUC0-6h) and incremental AUC0-6h were additionally calculated by using the linear trapezoidal method. After consumption of NALC and ALC, (+)-catechin and (-)-catechin were mostly not detectable in plasma, in contrast to epicatechin. For epicatechin, total AUC0-6h was different between both treatments, but not incremental AUC0-6h. Most kinetic parameters were similar for both treatments, but they varied strongly between individuals. Thus, epicatechin is the main monomeric flavan-3-ol in plasma after cocoa consumption. Whether NALC should be preferred against ALC due to its higher (-)-epicatechin content remains unclear with regard to the results on incremental AUC0-6h. Future studies should investigate epicatechin metabolites in plasma for a period up to 24 h in a larger sample size, taking into account genetic polymorphisms in epicatechin metabolism and should consider all metabolites to understand inter-individual differences after cocoa intake.

Impact of a Usual Serving Size of Flavanol-Rich Cocoa Powder Ingested with a Diabetic-Suitable Meal on Postprandial Cardiometabolic Parameters in Type 2 Diabetics-A Randomized, Placebo-Controlled, Double-Blind Crossover Study.

Randomized controlled trials indicate that flavanol-rich cocoa intake may improve postprandial glucose and lipid metabolism in patients with type 2 diabetes (T2D), based on studies with meals that impose a strong metabolic load. Hence, the aim of the present study was to investigate whether flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal may beneficially affect glucose, lipid metabolism, and blood pressure (BP) in patients with T2D. Twelve adults with T2D, overweight/obesity, and hypertension ingested capsules with 2.5 g of flavanol-rich cocoa or microcrystalline cellulose with a diabetic-suitable breakfast in a randomized, placebo-controlled, double-blind crossover study. BP was measured and blood samples were taken before, 2 and 4 h after breakfast and capsule intake. Cocoa treatment did not affect glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), triglycerides, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, and BP. For glucose, insulin and HOMA-IR, only effects by time were observed after both treatments. Thus, 2.5 g of flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal does not seem to affect postprandial glucose and lipid metabolism and BP in stably-treated diabetics. Nevertheless, future studies with close-meshed investigations are desirable, providing realistic amounts of cocoa together with realistic meals rich in carbohydrates to subjects with T2D or metabolic syndrome, which do not afford pharmacological treatment.

Regular Intake of a Usual Serving Size of Flavanol-Rich Cocoa Powder Does Not Affect Cardiometabolic Parameters in Stably Treated Patients with Type 2 Diabetes and Hypertension-A Double-Blinded, Randomized, Placebo-Controlled Trial.

Regular cocoa consumption has been shown to improve blood pressure (BP), insulin sensitivity, and lipid levels in patients with type 2 diabetes (T2D), using up to 100 g of chocolate or 54 g of cocoa. These effects, attributed to cocoa flavanols, would be beneficial for patients with T2D if they could be achieved by a usual serving size of flavanol-rich cocoa. Forty-two hypertensive patients with T2D (stable pharmacological treatment, with good adjustment for glucose metabolism, lipids, and BP) ingested capsules with 2.5 g/day of a flavanol-rich cocoa or cocoa-free capsules for 12 weeks in a double-blinded, randomized, placebo-controlled study with parallel group design. Participants had to maintain diet, lifestyle, and medication. Before and after intervention, fasting blood samples were collected; BP and nutritional status were investigated. Cocoa treatment did not affect BP, nor glucose metabolism (glucose, HbA1c, insulin, HOMA-IR) and lipids (triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol). Body weight, fat mass, and nutrient supply remained unchanged. Changes in the placebo group did not occur. Regular intake of a usual serving size of flavanol-rich cocoa does not improve cardiometabolic parameters in stably treated patients with T2D and hypertension. As the medication modulates partly the same targets as cocoa flavanols, future studies should focus on the preventive effect of cocoa against diabetes and other cardiometabolic diseases in individuals with preexisting abnormalities that do not require any pharmacological treatment.

A nutritive dose of pure (-)-epicatechin does not beneficially affect increased cardiometabolic risk factors in overweight-to-obese adults-a randomized, placebo-controlled, double-blind crossover study.

Background: Regular cocoa consumption has been shown to reduce blood pressure, improve lipid profiles, and increase insulin sensitivity and flow-mediated dilatation in healthy adults. It is assumed that these effects can be attributed to polyphenolic cocoa ingredients such as flavanols, especially to (-)-epicatechin. Nutritive intervention studies to prove this hypothesis are scarce. Objective: We aimed to evaluate whether regular consumption of 25 mg of pure (-)-epicatechin can affect increased cardiometabolic risk factors [blood pressure, glucose and lipid metabolism, low-density lipoprotein (LDL) oxidation] in overweight-to-obese subjects. Design: Forty-eight overweight or obese nonsmokers [body mass index (kg/m2) ≥25.0, ages 20-65 y] with clear signs of metabolic syndrome (blood pressure ≥130/85 mm Hg, glucose >5.55 mmol/L, or triglycerides >1.69 mmol/L or cholesterol >5.2 mmol/L in fasting blood) and without chronic diseases were included in a randomized, placebo-controlled, double-blind crossover study. Participants ingested daily 25 mg (-)-epicatechin (encapsulated) or placebo for 2-wk in random order (2-wk washout). After an overnight fast, blood pressure was monitored and blood samples were collected before and after both treatments. Anthropometric data were determined at each visit. Dietary intake was assessed by 3-d food records during both treatments and during run-in and washout phase. Results: Supplementation of pure (-)-epicatechin did not significantly affect blood pressure, glucose, insulin, homeostasis model assessment of insulin resistance, triglycerides, or total, LDL, or HDL cholesterol. Oxidized LDL, vitamins C and E, and ß-carotene in plasma were not modulated. Body weight, fat mass, fat distribution, and the intake of energy, nutrients, and (-)-epicatechin from food remained stable throughout the study. Conclusions: Daily intake of 25 mg of pure (-)-epicatechin for 2 wk does not reduce cardiometabolic risk factors in overweight-to-obese adults. Thus, the hypothesis that the cardioprotective effects of regular cocoa consumption are exclusively ascribed to (-)-epicatechin should be reconsidered. The study was registered at the German Clinical Trial Register as DRKS-ID: DRKS00009846.

Oral High-Dose Vitamin D Dissolved in Oil Raised Serum 25-Hydroxy-Vitamin D to Physiological Levels in Obese Patients After Sleeve Gastrectomy-A Double-Blind, Randomized, and Placebo-Controlled Trial.

BACKGROUND: Osteomalacia and cardiometabolic disorders are favored in morbidly obese patients due to an inadequate vitamin D (VD) status. Former trials supplementing orally VD (20-50 µg/day) in crystalline form after sleeve gastrectomy (SG) could not stabilize serum 25-hydroxycholecalciferol levels at predefined concentrations (≥50 nmol/l). We hypothesized that VD in an oily suspension would increase its bioavailability resulting in normal serum VD levels minimizing markers of cardiometabolic risk. METHODS: Morbidly obese patients (n = 94, BMI 51.8 ± 11.5 kg/m(2)) received orally 80 µg/day VD3 dissolved in oil or placebo (pure oil) in a randomized, double-blind, parallel-group study for 12 weeks after SG. 25-hydroxycholecalciferol, parathyroid hormone, albumin, alkaline phosphatase, phosphate, magnesium, calcium, creatinine, C-reactive protein, lipids, glucose, and glycated hemoglobin were determined in serum/plasma before surgery and after 4 and 12 weeks of supplementation. Intake of energy, fat, and VD were monitored using a 3-day food record. RESULTS: Seventy-nine patients were included in statistical analysis. Preoperatively, 77.2 and 40.5 % presented 25-hydroxycholecalciferol levels <75 and <50 nmol/l, respectively. After 12 weeks of supplementation, significantly more patients in the VD group exhibited levels >50 nmol/l (92 %) and >75 nmol/l (68 %) compared to the placebo group (54 and 22 %, respectively). Parameters of mineral metabolism and cardiometabolic risk were not modulated by intervention. CONCLUSION: Supplementation of 80 µg/day VD3 by oil is an effective and safe measure to prevent VD deficiency and to treat a preexisting undersupply in patients after SG. Cardiometabolic risk factors were, however, not affected; probably, higher VD doses might be necessary. CLINICAL TRIAL REGISTRATION: This trial was registered retrospectively on November 14, 2014, at the German Clinical Trials Register as DRKS00007143.

Kinetics of L-theanine uptake and metabolism in healthy participants are comparable after ingestion of L-theanine via capsules and green tea.

L-Theanine, an amino acid in green tea, is suggested to improve cognition and mood. Therefore, L-theanine is available as a supplement and is now used as an ingredient in functional drinks. Because data on the metabolic fate of L-theanine from human studies are lacking, we investigated the kinetics of L-theanine uptake and its metabolites, ethylamine and glutamic acid, in healthy participants. Within a randomized crossover study, 12 participants ingested a bolus of 100 mg L-theanine via capsules or green tea. On further occasions, 3 participants received 50 and 200 mg L-theanine via capsules. Blood and urine were collected before and up to 24 h postconsumption to determine the concentrations of L-theanine, proteinogenic amino acids, and ethylamine in plasma, erythrocytes, and urine by HPLC. L-Theanine increased in plasma, erythrocytes, and urine with comparable results after both treatments. The maximum plasma concentration of L-theanine occurred 0.8 h after intake of 100 mg L-theanine via capsules (24.3 ± 5.7 µmol/L) and tea (26.5 ± 5.2 µmol/L), respectively. The AUC of L-theanine in plasma increased dose dependently after intake of 50, 100, and 200 mg L-theanine via capsules. Moreover, ethylamine and glutamic acid increased in plasma and were excreted by urine after intake of capsules and tea. In conclusion, L-theanine is rapidly absorbed and seems to be hydrolyzed to ethylamine and glutamic acid. A minor part of L-theanine is retained in erythrocytes. Kinetics and urinary excretion of L-theanine, ethylamine, and glutamic acid are comparable after both treatments. Thus, functional effects of L-theanine intake may result from L-theanine, ethylamine, or glutamic acid.

Epicatechin ingested via cocoa products reduces blood pressure in humans: a nonlinear regression model with a Bayesian approach.

BACKGROUND: Four meta-analyses of randomized controlled trials (RCTs) based on the classical random-effects model showed that cocoa consumption can reduce systolic blood pressure (SBP) and diastolic blood pressure (DBP). Because epicatechin is suggested to be responsible for the treatment effect, changes in blood pressure should depend on the dose of ingested epicatechin, which may explain the between-study differences. OBJECTIVE: The objective was to quantify the effect of epicatechin ingested via cocoa products on changes in SBP and DBP. DESIGN: A nonlinear meta-regression model was chosen to investigate the impact of the epicatechin dose on changes in SBP and DBP. A Bayesian approach using Markov chain Monte Carlo methods was applied for an appropriate treatment of the nonlinearity. RESULTS: Data from 16 RCTs on SBP and 15 RCTs on DBP were included. The dose of epicatechin ingested via cocoa products influenced the changes in SBP and DBP. The asymptotic limit for the reduction was estimated at -4.6 mm Hg (95% CI: -5.4, -3.9 mm Hg) for SBP and at -2.1 mm Hg (95% CI: -2.7, -1.6 mm Hg) for DBP. An intake of 25 mg epicatechin/d led to a mean reduction of -4.1 mm Hg (95% CI: -4.6, -3.6 mm Hg) in SBP and of -2.0 mm Hg (95% CI: -2.4, -1.5 mm Hg) in DBP. CONCLUSIONS: Blood pressure reduction by consumption of cocoa products depends on the dose of ingested epicatechin, which explains most of the between-study differences in classical meta-analyses. Similar effects may be achieved by consumption of other foods that are also rich in epicatechin.

Geostatistical analysis of the spatiotemporal dynamics of powdery mildew and leaf rust in wheat.

Plant diseases are dynamic systems that progress or regress in spatial and temporal dimensions. Site-specific or temporally optimized disease control requires profound knowledge about the development of each stressor. The spatiotemporal dynamics of leaf rust (Puccinia recondite f. sp. tritici) and powdery mildew (Blumeria graminis f. sp. tritici) in wheat was analyzed in order to evaluate typical species-dependent characteristics of disease spread. During two growing seasons, severity data and other relevant plant growth parameters were collected in wheat fields. Spatial characteristics of both diseases were assessed by cluster analyses using spatial analysis by distance indices, whereas the temporal epidemic trends were assessed using statistical parameters. Multivariate statistics were used to identify parameters suitable for characterizing disease trends into four classes of temporal dynamics. The results of the spatial analysis showed that both diseases generally occurred in patches but a differentiation between the diseases by their spatial patterns and spread was not possible. In contrast, temporal characteristics allowed for a differentiation of the diseases, due to the fact that a typical trend was found for leaf rust which differed from the trend of powdery mildew. Therefore, these trends suggested a high potential for temporally optimized disease control. Precise powdery mildew control would be more complicated due to the observed high variability in spatial and temporal dynamics. The general results suggest that, in spite of the high variability in spatiotemporal dynamics, disease control that is optimized in space and time is generally possible but requires consideration of disease- and case-dependent characteristics.