[Basic health indicators in the NutrIMSS program: a retrospective study]. / Indicadores básicos de salud en el programa NutrIMSS: estudio retrospectivo.

Background: The NutrIMSS program is granted to populations with chronic conditions to improve basic health indicators and its effectiveness in this population is unknown. Objective: To analyze the change in the basic health indicators of patients who attended the NutrIMSS Program, at the UMF No. 2 of the IMSS in Mexico City, during the period 2018 to 2019. Material and methods: From 105 files of IMSS beneficiaries, a retrospective cohort study was carried out considering two measurements, before and after the NutrIMSS program. To evaluate the average change over time of health indicators, GEE models (Generalized Estimation Equations) and multiple linear regression models were used. Statistical analysis was used using the statistical program StataCorp 2015. Results: Patients who attended the Program showed changes between the beginning and end of the period with an average of three months of follow-up. They presented a decrease in the following health indicators: body weight of 1 kg, body mass index: 0.8 kg/m2, glucose of 13 mg/dL, triglycerides of 57 mg/dL and cholesterol of 17 mg/dL (p < 0.005 in all cases). There was no difference in the level of blood pressure. Conclusions: The NutrIMSS program influenced the improvement of the health indicators of the population of the program and is an ally to improve the health of the IMSS beneficiary population.

Introducción: el programa NutrIMSS se otorga a población con padecimientos crónicos para mejorar los indicadores básicos de salud; sin embargo, se desconoce su efectividad en esta población. Objetivo: analizar el cambio en los indicadores básicos de salud de pacientes que acudieron al programa NutrIMSS, en la UMF No. 2 del Instituto Mexicano del Seguro Social (IMSS) en la Ciudad de México, durante el periodo 2018 a 2019. Material y métodos: a partir de 105 expedientes de derechohabientes del IMSS se realizó un estudio de cohorte retrospectiva, considerando dos mediciones, antes y después del programa NutrIMSS. Para evaluar el cambio promedio en el tiempo de los indicadores de salud se utilizaron modelos GEE (Ecuaciones de Estimación Generalizadas) y modelos de regresión lineal múltiple. Para el análisis estadístico se utilizó el programa estadístico StataCorp 2015. Resultados: los pacientes que acudieron a NutrIMSS mostraron cambios entre el inicio y el fin del periodo, con un promedio de seguimiento de tres meses. Presentaron una disminución en los siguientes indicadores de salud: peso corporal de 1 kg, índice de masa corporal: 0.8 kg/m2, glucosa de 13 mg/dL, triglicéridos de 57 mg/dL y colesterol de 17 mg/dL (p < 0.005, en todos los casos). No se presentó diferencia en el nivel de la tensión arterial. Conclusiones: el programa NutrIMSS influyó para mejorar los indicadores de salud de la población del programa y es un aliado en la mejora de la salud de la población derechohabiente del IMSS.

Saturated fat replacement in short dough biscuits with HPMC and lecithin stabilised nanoemulsions.

Biscuits contain high proportions of saturated fats, which could lead to an adverse health effect. The objective of this study was to study the functionality of a complex nanoemulsion (CNE), stabilised with hydroxypropyl methylcellulose and lecithin, when used as a saturated fat replacer in short dough biscuits. Four biscuit formulations were studied including a control (butter) and three formulations where 33% of the butter was replaced with either extra virgin olive oil (EVOO), with CNE, or with the individual ingredients of the nanoemulsion added separately (INE). The biscuits were evaluated by texture analysis, microstructural characterisation, and quantitative descriptive analysis by a trained sensory panel. The results showed that incorporation of CNE and INE yielded doughs and biscuits with significantly higher (p < 0.05) hardness and fracture strength values than the control. The doughs made of CNE and INE showed significantly less oil migration during the storage than EVOO formulations, which was confirmed by the confocal images. The trained panel did not find significant differences in crumb density and hardness on the first bite among CNE, INE and the control. In conclusion, nanoemulsions stabilised with hydroxypropyl methylcellulose (HPMC) and lecithin can work as saturated fat replacers in short dough biscuits, providing satisfactory physical characteristics and sensory attributes.

'Raising the Pulse': The environmental, nutritional and health benefits of pulse-enhanced foods.

Diet is a key modulator of non-communicable diseases, and food production represents a major cause of environmental degradation and greenhouse gas emissions. Yet, 'nudging' people to make better food choices is challenging, as factors including affordability, convenience and taste often take priority over the achievement of health and environmental benefits. The overall 'Raising the Pulse' project aim is to bring about a step change in the nutritional value of the UK consumers' diet, and to do so in a way that leads to improved health and greater sustainability within the UK food system. To achieve our objectives, UK-specific faba bean production systems that optimise both end users' diets and environmental and economic sustainability of production will be implemented in collaboration with key stakeholders (including industry, the retail sector and government). Palatable faba bean flours will be produced and used to develop 'Raising the Pulse' food products with improved nutritional profile and environmental value. Consumer focus groups and workshops will establish attitudes, preferences, drivers of and barriers to increased consumption of such products. They will inform the co-creation of sensory testing and University-wide intervention studies to evaluate the effects of pulses and 'Raising the Pulse' foods on diet quality, self-reported satiety, nutritional knowledge, consumer acceptance and market potential. Nutrient bioavailability and satiety will be evaluated in a randomised-controlled postprandial human study. Finally, a system model will be developed that predicts changes to land use, environment, business viability, nutrition and human health after substitution of existing less nutritionally beneficial and environmentally sustainable ingredients with pulses. Government health and sustainability priorities will be addressed, helping to define policy-relevant solutions with significant beneficial supply chain economic impacts and transformed sustainable food systems to improve consumer diet quality, health and the environment.

Development of Saturated Fat Replacers: Conventional and Nano-Emulsions Stabilised by Lecithin and Hydroxylpropyl Methylcellulose.

The combination of two emulsifiers, lecithin and hydroxypropyl methylcellulose (HPMC), into emulsions is an interesting strategy to design fat replacers in food matrices. The objective of this study was to investigate the effect of HPMC type and concentration on the formation, stability, and microstructure of conventional emulsions and nanoemulsions. Two different types of HPMC with low and high content of methyl and hydroxypropyl groups (HPMC-L and HPMC-H) were evaluated. The results showed that the molecular structure and concentration of HPMC play a major role in the viscoelastic behaviour, the gelation temperature, and the strength of gel formed. The firmness and work of shear of HPMC solutions increased significantly (p < 0.05) with increasing concentration. HPMC-L illustrated a more stable gel structure than the HPMC-H solution. Nanoemulsions showed lower moduli values, firmness, and work of shear than conventional emulsions due to the influence of high-pressure homogenization. A combination of lecithin and HPMC improved the physical and lipid oxidative stability of the emulsions, presenting a lower creaming index and thiobarbituric acid reactive substances (TBARS). In conclusion, HPMC-L at 2% w/w could be a suitable type and concentration combined with lecithin to formulate a saturated fat replacer that could mimic butter technological performance during food manufacturing operations.

Physical and Chemical Characterisation of Conventional and Nano/Emulsions: Influence of Vegetable Oils from Different Origins.

The processes of oil production play an important role in defining the final physical and chemical properties of vegetable oils, which have an influence on the formation and characteristics of emulsions. The objective of this work was to investigate the correlations between oils' physical and chemical properties with the stability of conventional emulsions (d > 200 nm) and nanoemulsions (d < 200 nm). Five vegetable oils obtained from different production processes and with high proportion of unsaturated fatty acids were studied. Extra virgin olive oil (EVOO), cold-pressed rapeseed oil (CPRO), refined olive oil (OO), refined rapeseed oil (RO) and refined sunflower oil (SO) were used in this study. The results showed that the physicochemical stability of emulsion was affected by fatty acid composition, the presence of antioxidants, free fatty acids and droplet size. There was a significant positive correlation (p < 0.05) between the fraction of unsaturated fatty acids and emulsion oxidative stability, where SO, OO and EVOO showed a significantly higher lipid oxidative stability compared to RO and CPRO emulsions. Nanoemulsions with a smaller droplet size showed better physical stability than conventional emulsions. However, there was not a significant correlation between the oxidative stability of emulsions, droplet size and antioxidant capacity of oils.

Investigating Methods to Mitigate Whey Protein Derived Mouthdrying.

Mouthdrying is commonly associated with whey protein fortified products. Therefore, mitigating strategies could be key to reducing mouthdrying and maximising the benefits from such products. Currently, few studies have successfully mitigated whey protein derived mouthdrying and this paper aims to investigate different strategies to reduce mouthdrying effects. Accordingly, a series of experiments were carried out with a trained sensory panel (n = 11). Two different whey protein food matrices were tested: (a) whey protein beverages (WPB) varying in lactose (0.05-12.4% w/v) and fat (0.9-7.2% w/v) levels and (b) whey protein fortified snacks: cupcakes with differing whey protein concentrate (WPC) powders (standard and heat-stable) and scones with varying fat content (with and without cream topping). Overall results suggested the tested strategies had limited significant effects on whey protein derived mouthdrying. Increasing lactose (9.4% w/v) in WPBs and fat levels (via cream topping) on scones significantly suppressed mouthdrying. However, all other tested strategies (increasing fat in WPBs and heat-stable WPC in cupcakes) had no significant effect on suppressing perceived mouthdrying. This work demonstrates the challenges with mitigating whey protein derived mouthdrying; however, cross-modal taste suppression and increasing lubrication warrant further investigation.

The Functionality of Inulin as a Sugar Replacer in Cakes and Biscuits; Highlighting the Influence of Differences in Degree of Polymerisation on the Properties of Cake Batter and Product.

Sugar has multiple roles in baked products; competing for water and as such reducing starch gelatinisation and gluten development, behaving as a fluid during cooking, recrystallising on cooling; roles which influence properties such as aeration, texture and mouthfeel. Partial replacement with inulin, can provide beneficial nutritional and functional properties. This paper investigated the degree of polymerisation (DP) of two commercial inulins and their influence on baked product properties as a 30% sugar replacer. The two inulins varied substantially in their proportion of longer fructans (32.7% compared to 17.5% of DP > 11). The lower DP inulin led to a cake batter with very similar viscoelastic properties to the standard sugar batter, and subsequently to a very similar baked cake crumb structure, cake texture and mouthfeel. The higher DP inulin led to a more viscous batter, and cake with a less homogenous crumb structure that was perceived to be dryer and more mouthcoating. The subsequent use of the lower DP inulin in a biscuit formulation resulted in a slightly less elastic dough and consequently a softer and less crunchy biscuit. In summary, the success of inulin in providing functional properties that can enable sugar reduction in baked products is dependent on the degree of polymerisation of the inulin and rheological parameters needed in the specific bakery matrix.

Optimization of a sponge cake formulation with inulin as fat replacer: structure, physicochemical, and sensory properties.

The effects of several fat replacement levels (0%, 35%, 50%, 70%, and 100%) by inulin in sponge cake microstructure and physicochemical properties were studied. Oil substitution for inulin decreased significantly (P < 0.05) batter viscosity, giving heterogeneous bubbles size distributions as it was observed by light microscopy. Using confocal laser scanning microscopy the fat was observed to be located at the bubbles' interface, enabling an optimum crumb cake structure development during baking. Cryo-SEM micrographs of cake crumbs showed a continuous matrix with embedded starch granules and coated with oil; when fat replacement levels increased, starch granules appeared as detached structures. Cakes with fat replacement up to 70% had a high crumb air cell values; they were softer and rated as acceptable by an untrained sensory panel (n = 51). So, the reformulation of a standard sponge cake recipe to obtain a new product with additional health benefits and accepted by consumers is achieved. Practical Application: In this study, fat is replaced by inulin in cakes, which is a fiber mainly obtained from chicory roots. Sponge cake formulations with reductions in fat content up to 70% are achieved. These high-quality products can be labeled as "reduced in fat" according to U.S. FDA (2009) and EU regulations (European-Union 2006).