Effects of Sucrose Replacement by Polyols on the Dough-Biscuit Transition: Understanding by Model Systems.

This study investigated the impacts of the complete substitution of sucrose by maltitol and/or sorbitol on the dough-crumb transition in biscuits. To this end, the phenomena of starch gelatinization/melting were studied at different moisture contents, both in the biscuit dough and model systems, by X-ray diffraction (XRD), differential scanning calorimetry (DSC), and by environmental scanning electron microscopy (ESEM). Observation of doughs in ESEM revealed sorbitol had a structure very different from sucrose and maltitol crystals. After forming the dough pieces, it could be seen that at least some sugar and maltitol crystals were still present while sorbitol flakes were solubilized. At a limiting real water content (~20% dry basis), adding sweeteners to the mixture increased the gelatinization temperature, more markedly for sucrose and maltitol, as well as increasing the enthalpy. These results were confirmed by the model systems analyses. The calorimetric study with mixing batch cells revealed that sorbitol dissolved completely while maltitol and sucrose competed with the flour constituents to capture water. The proportion of water available for the sorption of the starch grain and its gelatinization was therefore different according to the affinity of the sweetener for water, and might influence the degree and temperature of starch gelatinization/melting.

Impact of Maltitol and Sorbitol on Technological and Sensory Attributes of Biscuits.

Overconsumption of sugars in diets is associated with many health problems, including dental diseases, diabetes and obesity. However, removing sugar from products such as biscuits is still a challenge for manufacturers and has been limited in Europe since the evolution of the EU regulation in January 2018, allowing only polyols and non-sweetening bulking agents as sugar substitutes. This study investigated the effects of fully replacing sugar with two polyols, maltitol and sorbitol, in short-dough biscuits. Morphological, textural and visual characteristics were studied as well as sensory properties. The reformulated biscuits were more compact in shape and structure. They were also less prone to checking, which was attributed to a more homogeneous water distribution at the end of baking, especially with sorbitol. Polyol biscuits were surprisingly colourful, especially sorbitol ones, although polyols are not normally involved in Maillard reactions. Sensory tests, however, showed a depreciation of the products compared to the control. Sorbitol biscuits were the least preferred but maltitol ones were quite well accepted compared to the control. Thus, maltitol is an excellent potential substitute for this type of product.

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters.

Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in adulthood (sexual abuse, street victimization). This study's objective was to describe the factors associated with the likelihood of post-traumatic stress disorder (PTSD) among homeless migrant mothers in the Paris region. Face-to-face interviews were conducted by bilingual psychologists and interviewers in a representative sample of homeless families in the Paris region. PTSD was ascertained using the Mini International Neuropsychiatric Interview (MINI) (n = 691 mothers). We studied PTSD in mothers using weighted Poisson regression. Homeless migrant mothers had high levels of PTSD (18.9%) in the 12 months preceding the study. In multivariate analysis, PTSD was associated with departure from the country of origin because of violence (PR = 1.45 95% CI 1.03; 2.04), depression in the preceding 12 months (PR = 1.82 95% CI 1.20; 2.76), and residential instability (PR = 1.93 95% CI 1.27; 2.93). Homeless migrant mothers have high levels of traumatic events and PTSD. Improvements in screening for depression and PTSD and access to appropriate medical care are essential for this vulnerable group.

Cervical cancer screening among homeless women in the Greater Paris Area (France): results of the ENFAMS survey.

Little is known about the prevalence of cervical cancer screening (CCS) and its correlates among homeless women in France. The objectives of this study were to determine the prevalence of women who had never been screened for cervical cancer and to identify the associated factors. This cross-sectional study was based on data collected in the ENFAMS survey, which was conducted in 2013 among 764 sheltered homeless mothers in the Greater Paris Area. Robust Poisson regression models were used to estimate the association between no lifetime CCS and certain sociodemographic and health-related factors (selected from the behavioral model of vulnerable populations). Analyses were carried out separately for women with and without a regular gynaecological follow-up (RGF). The proportion of never-screeners was 33% among the women with an RGF versus 64% among those without an RGF (P<0.001). Among the latter, never having been screened for CCS was associated mainly with socioeconomic conditions, the length of time lived in France, a history of delivery in France and the duration of homelessness. In those with an RGF, the factors were mainly poor health service utilization and language difficulties. This first quantitative study of CCS among homeless women in the Greater Paris Area points to the need for it to be proposed and performed more systematically in primary care. Every contact between this hard-to-reach population and health services should be an opportunity to check their screening status and to ensure that those in need actually undergo a Pap test.

Characteristics and health of homeless families: the ENFAMS survey in the Paris region, France 2013.

BACKGROUND: The objectives were to estimate the size of homeless family population in Paris region, to describe their living conditions and health and to analyse the impact of homelessness on children's growth and development, which was never investigated in France. METHODS: A cross-sectional survey was conducted on a random sample of homeless sheltered families in 2013. Families were interviewed in 17 languages and a nurse took anthropometric measures, blood samples and collected health data from child health reports. RESULTS: The population size was estimated at 10 280 families. Half were single-parent female families and 94% were born outside France. Most families had experienced housing instability and 94% were living below the poverty line (828 euros/month). Malnutrition was a major problem: the prevalence of food insecurity was high (77% of parents and 69% of children), as well as anaemia (50% of mothers and 38% of children), overweight (38% of mothers and 22% of children) and obesity (32% of mothers and 4% of children). High rates of depressive disorders were found in 30% of homeless mothers and 20% of children had signs of possible mental health disorders. DISCUSSION: These first results highlight the important number of families among the homeless population in Paris region. Families differed from other homeless people regarding social characteristics such as birthplace, single-parent status and residential instability that are likely to influence schooling, social ties, health and access to care. These results demonstrate the need for urgent actions targeting homeless families, in terms of reducing housing instability and providing adequate care, especially for children.