Effects of whole-grain barley and oat ß-glucans on postprandial glycemia and appetite: a randomized controlled crossover trial.

This study aimed to determine the postprandial effects of barley bread (BB) and oat bread (OB), grain sources of ß-glucans, on glycaemia and appetite by comparison with white bread (WB) and whole-wheat bread (WWB). This randomized controlled crossover trial included 20 healthy individuals (10 males and 10 females) who consumed WB, WWB, BB, and OB with a standard breakfast followed by an ad libitum lunch. Postprandial glucose and appetite responses were quantified as the incremental area under the curve (iAUC). Although the iAUC for glycaemic response was lower by 23.7%, 29.9%, and 27.9% after the consumption of BB, OB, and WWB compared with WB (p = 0.023), no differences were observed between BB, OB, and WWB (p > 0.05). BB had a lower iAUC for appetite sensation by 21.5%, 23.9%, and 55.7% compared with WB, WWB, and OB (p = 0.005). OB had no effect on appetite and was also less palatable than BB. Subsequent food intakes were similar after the consumption of all test breads (p > 0.05). The encouragement of healthier bread formulations that can beneficially modulate postprandial glycemia and appetite may contribute to the promotion of public health. This trial was registered at ClinicalTrials.gov as NCT04749498.

The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents.

INTRODUCTION: This study aimed to investigate the association of diet quality (DQ) and dietary acid load (DAL) with insulin resistance (IR) in overweight children and adolescents. MATERIALS AND METHODS: The study was conducted on 135 overweight participants aged 6-17 years. DQ was assessed using the Healthy Eating Index 2015 (HEI-2015) and the HEI-2015-TUBER, revised in accordance with the Turkey Dietary Guidelines (TUBER). Estimation of DAL was made calculating the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. RESULTS: The HEI-2015-TUBER score was lower in those with IR than in those without IR (p=0.021). Higher PRAL and NEAP scores were found in those with IR (p=0.060 and p=0.044, respectively). Moreover, a one-unit increase in the HEI-2015-TUBER score and the DAL score was associated with a reduction of 4.2% and a rise of approximately 3% in IR risk, respectively. CONCLUSIONS: Healthy eating habits in overweight paediatric groups may help to reduce the IR risk, improving DQ and decreasing DAL.

The food service quality and its effects on nutritional status in nursing home residents.

BACKGROUND & AIMS: There are studies in the literature that consider only the opinions of older adults about food service or only the status of meeting dietary needs to evaluate the quality of food services. However, evaluating both satisfaction (residents' perspective) and nutritional adequacy (experts' perspective) together is important for ensuring adequate food intake and meeting dietary requirements. This study aimed to evaluate the quality of nursing home food service from both perspectives and to detect its effects on older adults' nutritional status. METHODS: A cross-sectional study was conducted on 101 older adults. Satisfaction with the food service and nutritional status was assessed using a questionnaire and the Mini Nutritional Assessment Short Form. RESULTS: The 28-days menu had higher energy for females, lower protein for males, higher fat and sodium for both genders, and inadequate micronutrient (vitamin B6, folic acid, vitamin B12, potassium, calcium, magnesium, etc.) contents than recommended. Older adults were 65.1% satisfied with food service, and dissatisfaction was associated with a decrease of 8.42%, 6.85%, and 6.25% in meeting their energy, protein, and fiber requirements, respectively, and an increase of almost 20 times in malnutrition risk. CONCLUSION: Our findings shed light on the importance of food service quality in nursing homes and of evaluating the satisfaction of residents, as well as the nutritional adequacy of menus.

Intuitive eating: associations with body weight status and eating attitudes in dietetic majors.

PURPOSE: Intuitive eating (IE), an adaptive eating pattern characterized by eating in response to physiological hunger and satiety cues, has been associated with positive psychosocial and physical health outcomes. This study aimed to determine associations between IE behavior with body weight status and eating attitudes in dietetic students and dietitians, who are a risky population for disordered eating and body dissatisfaction. METHODS: Participants (n = 785) completed a self-administered questionnaire which featured socio-demographic characteristics, the eating attitudes test 26, the three-factor eating questionnaire, and the intuitive eating scale-2 with four facets unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on hunger and satiety cues (RHSC) and body-food choice congruence (B-FCC). RESULTS: When controlled for potential covariates in the multivariate regression analysis, greater total IE and all subscale scores were associated with reduced BMI in dietetic majors having a BMI of ≥ 18.5 kg/m2 (p < 0.05). Participants with a high IE score had 41%, 74%, and 89% lower risk of developing an eating disorder, uncontrolled eating, and emotional eating, respectively (p < 0.001). While higher UPE, EPR, and RHSC scores were associated with lower odds of disordered eating (p < 0.001), EPR, RHSC, and B-FCC scores were inversely related to the risk of uncontrolled eating and emotional eating (p < 0.05). CONCLUSION: Considering these inverse associations, IE may be helpful for weight management and a useful skill to reduce eating disorder symptomatology among the dietetic community. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Do children with solitary or hypofunctioning kidney have the same prevalence for masked hypertension?

BACKGROUND: Having a low nephron number is a well-known risk factor for hypertension. There is an inverse relationship between the filtration surface area and systemic hypertension. A significant percentage of masked hypertension can be detected in children with nephron loss by ambulatory blood pressure monitoring (ABPM). METHODS: We prospectively investigated ABPM results of children having reduced kidney mass with normal office blood pressures (BPs) and kidney function. Forty-three children with congenital solitary kidney (group 1), 11 children with acquired solitary kidney (group 2), and 76 children with hypofunctioning kidney (group 3) were compared with age, gender, and BMI-matched healthy control group (group 4). The dietary salt intake of 76 patients was evaluated as salt equivalent (g/day). The primary endpoint was change from baseline in mean 24-h ABPM variables and the proportion of patients with masked hypertension when assessed by ABPM. RESULTS: The masked hypertension ratio of all patients was 12.3% when assessed with ABPM. Night hypertension was significantly higher in all patient groups than in the control group (p = 0.01). Diastolic BP loads of groups 1 and 3 were higher than in controls (p = 0.024). Systolic BP loads were higher only in group 1 than in the control group (p = 0.003). The dietary salt equivalent of patients in group 1 correlated positively with 24-h SBP and mean arterial pressure (MAP) values. Patients with excessive dietary salt intake in group 1 had a significantly higher diastolic BP load than those without excessive salt intake in group 1 (p = 0.002). CONCLUSIONS: Masked hypertension can be seen in children with a solitary kidney or when one of the kidneys is hypofunctioning. Systolic BP loads are higher in children with congenital solitary kidney, and salt intake correlates with systolic BP profiles especially in those. Our results suggest that being born with a congenital solitary kidney increases predisposition to hypertension and salt sensitivity.

Breakfast and dinner insulin index and insulin load in relation to overweight in children and adolescents.

PURPOSE: Hyperinsulinemia is related to the development of several chronic diseases, particularly obesity. Therefore, this study aimed to examine the association between the insulinemic potential of both total diet and meals, measured by the glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL), and overweight risk among children and adolescents. METHODS: This cross-sectional study was conducted on 205 overweight and 146 normal-weight participants aged 6-18 years. Overweight was defined as body mass index ≥ 85th percentile of Turkish growth-reference data. Through the use of standard methodology, dietary and meal GI, GL, II, and IL were derived from dietary data collected via a 3-day dietary record. Associations were investigated using multivariable-adjusted regression analysis. RESULTS: When controlling for potential covariates, a greater dietary II (OR 2.69, 95% CI 1.28, 5.68) and IL (OR 5.22, 95% CI 2.39, 11.38), as well as GL (OR 3.89, 95% CI 1.77, 8.56), was strongly associated with higher odds of overweight (both Pfor trend < 0.001). Furthermore, breakfast GL (OR 4.87, 95% CI 2.15, 11.01), II (OR 3.88, 95% CI 1.79, 8.39), IL (OR 4.93, 95% CI 2.20, 11.05) and dinner GL (OR 2.39, 95% CI 1.10, 5.20), II (OR 3.81, 95% CI 1.73, 8.41), IL (OR 3.63, 95% CI 1.67, 7.91) were found to be a significant independent predictor of overweight (all Pfor trend < 0.001) in pediatric population. CONCLUSION: Our results suggest that dietary insulin demand, particularly for breakfast and dinner, was independently associated with overweight in children and adolescents. These findings may shed light on the relevance of considering meal insulin demand while developing dietary strategies in this population.

The comparison of two mealtime insulin dosing algorithms for high and low glycaemic index meals in adolescents with type 1 diabetes.

AIMS: Postprandial glycaemic variability carries on being a clinical challenge in optimizing glucose control in type 1 diabetes. The aim of this study was to compare the postprandial glycaemic effects of carbohydrate counting and food insulin index algorithms following the consumption of protein-rich, high-fat meals with different glycaemic index (GI) in adolescents with type 1 diabetes. METHODS: A randomized, single-blind and crossover trial included 15 adolescents aged 14-18 years with type 1 diabetes. Participants consumed two different test meals with similar energy, macronutrients and food insulin index but the approximately twofold difference in GI, in random order on four consecutive mornings at their home. Insulin dose for high- and low-GI test meals was determined by using the carbohydrate counting and food insulin index algorithms. Four-hour postprandial glycaemia was assessed by the continuous glucose monitoring system. RESULTS: Compared with carbohydrate counting, the food insulin index algorithm significantly decreased peak glucose excursion (-57%, p = 0.02), incremental area under the curve (-65%, p = 0.02) and coefficient variation of blood glucose (-37%, p = 0.03) in the high-GI meal, though there was no difference between the two algorithms in the low-GI meal. The occurrence of hypoglycaemia did not significantly differ between insulin dosing algorithms for the high-GI (p = 0.58) and low-GI (p = 0.20) meals. CONCLUSIONS: The food insulin index algorithm may be beneficial for postprandial glycaemic control after the consumption of high-GI meals in adolescents with type 1 diabetes.

The effects of kefir in mixed meals on appetite and food intake: a randomized cross-over trial / Os efeitos do quefir em refeições mistas sobre o apetite e a ingestão de alimentos: um estudo randomizado cruzado

ABSTRACT Objective The natural probiotic kefir is fermented milk, and may have effects on satiety and voluntary energy intake. This randomized crossover trial aimed to determine whether kefir, consumed with low- or high-glycemic index meals, affects appetite and subsequent food intake. Methods Twenty four healthy females aged 21-24 years, were recruited from Erciyes University and the surrounding community. The participants were submitted to three different breakfasts: a low glycemic index accompanied by milk, a low glycemic index with kefir, and a high glycemic index with kefir, with a 1-week washout period between meals. At 0, 15, 30, 60, 90, 120, 150, and 180 minutes after the meal, appetite ratings were measured by the visual analog scale, and then ad libitum lunch was served. Results No differences in appetite scores and voluntary energy intake were detected between the test meals. Furthermore, palatability ratings were similar between test meals, except for the higher score of high glycemic index kefir for overall palatability. Conclusion This study demonstrated that adding kefir to a high glycemic index meal may prevent increases in appetite and food intake, resulting in postprandial responses similar to those of a low glycemic index meal. These findings might enable the development of novel dietary strategies based on appetite regulation to treat or prevent obesity, particularly for Western societies. This trial was registered at ClinicalTrials.gov under the process NCT03636217.

RESUMO Objetivo O quefir probiótico natural é um leite fermentado, e pode ter alguns efeitos sobre a saciedade e a ingestão voluntária de energia. Este ensaio cruzado randomizado teve como objetivo determinar se o quefir consumido com uma refeição de baixo ou alto índice glicêmico teria afetado o apetite e a ingestão de alimentos subsequente. Métodos Vinte e quatro mulheres saudáveis, com idades entre 21 e 24 anos, foram recrutadas na Universidade de Erciyes e na comunidade circundante. Todas as participantes foram submetidas a três cafés da manhã diferentes: um baixo índice glicêmico e leite, um baixo índice glicêmico e quefir, e um alto índice glicêmico e quefir, com um período de lavagem de 1 semana entre as refeições. Aos 0, 15, 30, 60, 90, 120, 150 e 180 minutos após a refeição, as classificações de apetite foram medidas por escala analógica visual e, em seguida, o almoço ad libitum foi servido. Resultados Não foram detectadas diferenças nos escores do apetite e na ingestão voluntária de energia entre as refeições do teste. Além disso, as classificações de palatabilidade foram semelhantes entre as refeições de teste, exceto o maior escore de alto índice glicêmico quefir para palatabilidade geral. Conclusão Este estudo demonstrou que a adição de quefir a uma refeição com alto teor de índice glicêmico pode impedir o aumento do apetite e da ingestão de alimentos, resultando em respostas pós-prandiais semelhantes a uma refeição com baixo teor de índice glicêmico. Esses achados poderiam permitir o desenvolvimento de novas estratégias dietéticas baseadas na regulação do apetite para tratar ou prevenir a obesidade, particularmente para a sociedade ocidental. Esse julgamento foi registado na ClinicalTrials.gov como NCT03636217.

Health-Related Quality of Life and Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus.

OBJECTIVE: The burdens imposed on a child and his/her parents by a diagnosis of type 1 diabetes mellitus (T1DM) adversely affect their health-related quality of life (HRQoL). HRQoL is important for prognosis and is related to metabolic control. To evaluate the HRQoL of Turkish children and adolescents with T1DM and to assess the correlation of HRQoL subscales (including physical and psychosocial health) with metabolic control, and particularly with hypo- and hyperglycaemic episodes. METHODS: This cross-sectional study included 70 participants with T1DM aged between 8 and 18 years (study group) and 72 healthy controls who were matched to the study group in terms of age, gender, and sociodemographic characteristics (control group), and their parents. HRQoL was determined by the Pediatric Quality of Life Inventory. As an indicator of metabolic control, the most recent hemoglobin A1c (HbA1c) levels were obtained and the number of hypo- and hyperglycaemic episodes over the past one month were checked. RESULTS: The study group had similar HRQoL scores for children's self-reports and parents' proxy-reports to the control group apart from a decreasing psychosocial health score for parents' proxy-reports in the study group. Although HbA1c level was not related to HRQoL scores, lower number of hypo- and hyperglycaemic episodes were associated with an increase in psychosocial health scores and physical health scores as well as an increase in the total score for parents' proxy-reports. CONCLUSION: Although there was no correlation between metabolic control and HRQoL in children's self-reports, the improving HRQoL levels in parents' proxy-reports were associated with good metabolic control.